ORAL ANSWERS TO QUESTIONS

HEALTH

The Secretary of State was asked—

Clinically Led Commissioning

Stephen Mosley: What assessment he has made of the effect on patients of clinically led commissioning.

Andrew Lansley: Clinical leadership in the design of services for patients will deliver better outcomes and improve patient experience of care. In the last year, for example, NHS Dorset clinical commissioning group has worked to improve outcomes in cardiology, dermatology and muscular-skeletal services, and NHS Nene CCG has admitted more than 3,000 patients on to a proactive care scheme, which I have had the privilege of seeing for myself, to identify and reduce the risks of people needing an emergency admission. That is one reason why the number of emergency admissions to hospital in the NHS fell by 1%.

Stephen Mosley: The Secretary of State will be aware of Chester’s location on the border with Wales and of the issues with cross-border health care commissioning. In order to ensure that there will be no financial shortfall for the West Cheshire CCG in relation to the treatment of patients who are registered with general practitioners in Wales but who receive treatment in England, will he confirm that the cross-border commissioning funding protocol between England and Wales will be fully implemented?

Andrew Lansley: I would be grateful if my hon. Friend could convey my best wishes to the Countess of Chester hospital, which I visited just before Christmas, and my appreciation of the work of the West Cheshire CCG. I can confirm that discussions between officials in the Welsh Government, my Department and the NHS Commissioning Board are under way to extend and renew the protocol for cross-border commissioning for 2013-14 and beyond.

Andy Slaughter: If the Secretary of State believes that the reconfiguration of hospitals is clinically rather than finance led, will he ensure that NHS North West London publishes full risk assessments of its decision to close four accident and emergency departments and replace them with urgent care centres?

Andrew Lansley: As the hon. Gentleman will—I hope—be fully aware, the view of Ministers is clear: any reconfiguration of services must be driven not by cost but by a need to improve clinical outcomes for patients; must be in line with the commissioning intentions of the local commissioning group; must be on the basis of strong patient and public engagement; and must protect the choice available to current and prospective patients. To that extent, I hope that all the necessary information to support those four tests is in the public domain.

Jo Johnson: GP commissioners in Bromley have opened a consultation on the future of services currently provided at the Orpington hospital site. Will the Secretary of State ensure that the administrator recently appointed to South London Healthcare trust takes account of the consultation’s findings when drawing up his proposals for how best to put SLHT on a sustainable clinical and financial footing?

Andrew Lansley: I hope that my hon. Friend is aware that when I appointed the trust special administrator and set a timetable for his work, I specifically added 30 days on an exceptional basis to the timetable for the production of his first report, one of the exceptional reasons being that an accelerated consultation should take place locally on the future of Orpington hospital.

Andy Burnham: I shall give the Secretary of State one last chance on rationing.

Simon Burns: Ooh!

Andy Burnham: The right hon. Gentleman needs to listen carefully to what I am about to say. Yesterday, he promised action to stop the restricting of cataract operations for financial reasons, if given evidence. How about this example? NHS Sussex has imposed severe restrictions that contradict the Department’s own guidance, “Action on Cataracts”, and this has seen the number of operations in Sussex fall from 5,646 in 2010 to 4,215 in 2011. Does the Secretary of State consider that fair to older people, and will he now take the action his Department has promised?

Andrew Lansley: I have made it clear to the right hon. Gentleman many times, as has the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns), that it is not acceptable and we will not allow NHS commissioners to impose blanket bans. I will gladly take note of and investigate that example, but I have to say that the right hon. Gentleman wrote to me with a document that purported to contain a series of examples from across the country, most of which turned out to be fictional. I shall respond in writing about NHS Sussex and put a copy in the Library of the House, but, as I have made clear, we, unlike our predecessors, will not accept any blanket ban on treatment. Any treatment must be clinically determined in the interests of patients.

Andy Burnham: Well, the right hon. Gentleman is accepting it, and he continues to dispute my evidence, but what does he say to the president of the Royal College of Ophthalmologists, who said yesterday of cataract restrictions:
	“They are arbitrary and are a response to financial pressures, not clinical needs”?
	The reason for the Government’s denial is that the financial pressures are greater than they care to admit. The figures released by the Treasury yesterday confirmed that he and the Government have now cut the NHS budget for two years running, but they also reveal something else: another real-terms cut planned for 2013-14. Do not their flagship promises on NHS spending now lie in shreds, and will this Prime Minister not be for ever remembered as the man who cut the NHS, not the deficit?

Andrew Lansley: It is staggering, isn’t it? In 2010-11, the NHS budget was set by the right hon. Gentleman, not by us. The final accounts for 2011-12 will not be published until the autumn. I wish he would just get up at the Dispatch Box and admit that over the course of this Parliament the coalition Government will increase the NHS budget in England by 1.8% in real terms, which is £12.5 billion in cash, whereas the Wales Audit Office has said that a Labour Government in Wales will cut the NHS budget over the same period by 10% in real terms.

Social Care

Mary Glindon: What steps he is taking to bring forward legislative proposals on the funding of social care.

Barbara Keeley: What steps he is taking to bring forward legislative proposals on the funding of social care.

Paul Burstow: The draft Care and Support Bill contains clauses that support our commitment to introduce a universal deferred payments scheme and a national eligibility threshold. We have set out our intention to base a new funding model on the principles of the Dilnot commission model and we will take a decision in the next spending review.

Mary Glindon: Last week the Secretary of State dismissed the concerns of Labour MPs about councils being hard pressed to find funds to implement any of the proposals. The Local Government Association stated that there was no money. Will the Minister now commit to legislation in this Parliament to sort out the funding of social care at local level?

Paul Burstow: It does not need legislation to sort out the amount of money that goes into social services; it does need legislation, however, to put in place a universal deferred payments scheme. We have made it clear that we will fully fund the commitment that we have already announced and we will work with the Local Government Association and others on its detailed design and implementation.

Barbara Keeley: The verdict of the Care and Support Alliance on the delay in introducing legislation to reform social care funding is this:
	“Each day of delay condemns greater numbers of older and disabled people to the risk of isolation and neglect,”
	trapping people in hospital and pushing many more carers to “breaking point”. Just when will the Government realise the damage done by delaying the decision to do anything about funding social care?

Paul Burstow: In fact, in October 2010 this Government took an important decision about the funding of social care: to invest an extra £7.2 billion. I wish Opposition Members would stop running local authorities down and support the ones that are doing the right thing and ensuring that they spend the money the Government have provided to them on social care, rather than cutting those services. That is what I am doing; I hope that the hon. Lady will as well. I just wish that she had prefaced her comments by apologising for 13 years of Labour failure on social care.

Stephen Dorrell: I welcome my hon. Friend’s statement today and the announcements last week about the future structure and the commitment to introduce legislation later in this Parliament in line with the draft Bill. Will he confirm that it is the Government’s intention to pursue the cross-party talks on funding options for the Dilnot package, and that if solutions can be found, they can be included in the legislation that is introduced?

Paul Burstow: Notwithstanding some of the perhaps intemperate exchanges we have in this place, my colleagues and I are still determined, if those on the Opposition Front Bench are, to engage in talks on how we reform the funding system. Indeed, the debate we had in the Chamber last night confirmed that both sides of the House wish to support the principles of the Dilnot reforms, so I hope that we can have such talks and that they can be reflected in the Bill.

David Burrowes: I welcome the Government’s commitment to support the provision of free and fully integrated end-of-life care. While the palliative care funding pilots are progressing, can lessons be learnt quickly in my borough of Enfield where, sadly, most people are dying in hospital rather than, as is their choice, at home or with the support of local hospices?

Paul Burstow: My hon. Friend is absolutely right. Just last week we published the world’s first ever survey of bereaved people’s experiences of the end-of-life care received by loved ones. It revealed quite stark variations from one part of the country to another, and will prove a valuable tool in driving up performance of areas that are not doing well by families in end-of-life care. As for the White Paper, we have said clearly that we are committed to doubling funding for the pilots to ensure that we have the data to take decisions about the introduction of free personal care when it comes to end of life.

Liz Kendall: Opposition Members are genuine in our desire to reach cross-party consensus on the funding of social care. Will the Minister demonstrate his Government’s seriousness by agreeing to include Treasury Ministers directly in the cross-party talks, as Labour has offered to do from the start?

Paul Burstow: Talks that start with lots of preconditions are not going to be very good talks to start with. The Government always retain the responsibility for making decisions about taxation and spending priorities. We set out our position last week on the Dilnot Commission, and we now have a clear basis for talks, as those on both sides of the House seem to agree on the principles of Dilnot as the basis for reform.

NHS Performance

Chris Kelly: What assessment he has made of the performance of the NHS in 2011-12; and if he will make a statement.

Andrew Lansley: At the beginning of this month, I laid my first annual report before the House setting out the achievements of the health service in 2011-12. The report showed that the NHS had continued to maintain or improve all the key performance standards while delivering unprecedented efficiency savings and a strong financial out-turn. That is a testament to the achievements of all NHS staff.

Chris Kelly: I thank my right hon. Friend for that answer. Will he confirm that the numbers of people waiting over 18 weeks, over 26 weeks and over 52 weeks for treatment are now at their lowest-ever levels—lower than when Labour was in office? Will he also confirm that that gives the lie to Labour’s claims that waiting lists are increasing?

Andrew Lansley: Yes; I am grateful to my hon. Friend. When we came into office, something like 209,000 people had waited over 18 weeks. We have reduced that figure to 160,000. The number waiting over a year was nearly 19,000, and we have brought that down to below 5,000. I remind Opposition Members that in Wales the target for the number waiting more than 26 weeks has not been met—the figure stands at 6%, whereas in England it is 2.2%.

Grahame Morris: In regard to improving cancer outcomes, will the Secretary of State consider using some of the underspend in the cancer drugs fund to allow improved access to advanced radiotherapy?

Andrew Lansley: I am grateful to the hon. Gentleman for that question, because it allows me to confirm that the annual report states that the NHS has met all the cancer waiting time standards, and that we in England have provided for 12,500 patients to have access, through the cancer drugs fund, to cancer drugs that they would not otherwise have been able to have. It is a matter of regret that a similar cancer drugs fund is not available for exceptional treatments in Wales.

John Pugh: What part or percentage of the £5.8 billion efficiency savings can be attributed to the salary freeze alone?

Andrew Lansley: If I may, I will write to my hon. Friend in order to convey the precise figure. From my recollection, I believe that the bulk of the £5.8 billion efficiency savings—£2.8 billion—was in the acute sector. As most of the acute sector’s costs are pay costs, the pay freeze will have contributed a significant part of that.

Diane Abbott: Will the Secretary of State accept that some of those so-called efficiency savings are totally counter-productive? Despite Ministers’ claims to be saving money on agency staff, is not the truth that hospitals’ attempts
	to improve their efficiency have backfired, with jobs being cut and agency staff being hired at rates as high as £1,600 a day?

Andrew Lansley: No, I will not accept any such thing. We are aiming to reduce agency staffing costs in the NHS under QIPP—the quality, innovation, productivity and prevention programme—by £300 million, and we have already made a reduction of more than £120 million. Since the election, in complete contrast to the situation beforehand, we have reduced the number of administrative staff in the NHS by 15,000, including a reduction of more than 6,000 managers. We have also increased the number of clinical staff by 4,000 since the election.

Social Care

Andrew Selous: What steps he is taking to improve the quality of care provided in residential and nursing homes.

Laura Sandys: What steps he is taking to improve social care services.

Paul Burstow: The White Paper introduces new measures to help us to deliver better quality services and to improve the care that people experience, including through greater transparency, with new provider quality profiles and new care audits. It also clarifies what quality in care and support means, by setting out principles, standards, roles and responsibilities for driving up the quality of care. The White Paper makes it clear that we will rule out crude commissioning by the minute, which turns care workers into clock-watchers, and that we will work with commissioners, care providers and people who use services and carers in order to bring to an end commissioning practices that undermine people’s dignity and choice.

Andrew Selous: I recently visited Ashton Lodge residential home in Dunstable, and I was delighted to hear from the residents how kind the staff were. Occasionally, however, I get letters from constituents detailing simply unacceptable levels of care for their family in residential homes. How can we involve local communities more so they take a role in ensuring that all residential homes have consistently high standards of care?

Paul Burstow: I am grateful for that question. Indeed, one of the issues set out in the White Paper is the collaboration by the Department of Health and others with leaders in the care sector to make sure that care homes become much more embedded as part of their local communities and much more genuinely open to their local communities—working with local schools and working with HealthWatch, which will have powers of entry to work with those care homes as well. By turning the spotlight on in a benign way, making sure that all care homes are more open to their public, I think we can significantly improve quality.

Laura Sandys: In parallel with the social care budget, do the Government see a strong role for GPs to look at prevention—putting in special monitoring as people get older to ensure that we stay younger and fitter for longer?

Paul Burstow: Indeed we do. We identify in the White Paper the fact that there has been a postcode lottery for many years when it comes to access to primary care in our care home sector. The White Paper sets out how to ensure that we begin to eradicate that postcode lottery. By establishing a national commissioning board to commission primary care, we can ensure greater consistency in the future.

Margaret Ritchie: What conversations has the Minister had with his counterpart in Northern Ireland in respect of protecting the high standards of residential and nursing care that already exist for the people in Northern Ireland?

Paul Burstow: I am grateful to the hon. Lady for her question. Indeed, officials in my Department are in close contact with officials in all the devolved Administrations to make sure that we share best practice across the nations so that we drive up the quality of care for all.

Andrew Gwynne: Only last week, the Secretary of State said about care:
	“The…number of delayed discharges is broadly the same as it was last year and, I believe, from memory, the year before—I will correct the record if not.”—[Official Report, 11 July 2012; Vol. 548, c. 322.]
	Figures published by his own Department show the number of delayed days is up by 18% in the last year and 29% since August 2010. Are Ministers completely out of touch with reality, or would the Minister now like to correct the record?

Paul Burstow: Of course what the hon. Gentleman omits to mention in seeking to give an impression is this: the implication is that social services are not coping with delayed discharges and are the principal cause of them, but the figures do not bear that proposition out. [Interruption.] Indeed, the extra investment the Government are making in reablement services means that discharges in this area are being assisted and improving—[Interruption.]

Mr Speaker: Order. The question has been asked, and the Minister is giving his answer. Members may like it or dislike it, but they have a duty to listen to it with courtesy. While I am about it, let me emphasise that there is far too much sedentary noise coming from both Front-Bench teams. I think that the Minister has finished his answer; we are grateful to him.

Insulin Pumps

Tom Greatrex: What assessment he has made of the availability of insulin pumps for young diabetics.

Simon Burns: We are currently undertaking a national audit to give us a clear picture of provision of pump services in England. This will be published shortly. The rapid response survey for 2010-11 suggests that half of all those eligible for a pump in England already have one, or have funding agreed—a significant improvement on the initial survey in 2010.

Tom Greatrex: I thank the Minister for that reply. I am sure he will be aware that Nicola Sturgeon, the Health Minister in the devolved Administration at Edinburgh, announced earlier this year that all the under-18s requiring an insulin pump would get one. My constituent 13-year-old Fiona Clark has been told by Yorkhill hospital in Glasgow that she will have to wait an unspecified time to receive the pump her doctors say she needs. Given that the National Institute for Health and Clinical Excellence estimates the standard benchmark rate for the uptake of insulin pump therapy for type 1 diabetes in England is 12.4%, will the Minister offer his Department’s assistance to help those in Scotland to get above the current paltry 3.1% uptake?

Simon Burns: I am extremely grateful to the hon. Gentleman, but as he will appreciate as a Scottish Member of Parliament, this is a devolved responsibility for the Scottish Government. On the specific issue—[Interruption.] If the right hon. Member for Leigh (Andy Burnham) would shut up, it would be helpful. It would probably be useful if the hon. Gentleman raised the specific issue with the Scottish Government, but on the general principle let me say that we are determined, certainly in England, to do all we can through education, the workings of the NHS and the operating framework to ensure that the number of people receiving pumps increases, as it already has in the last two years.

Nursery Milk Scheme

Diana Johnson: How many children received milk through the nursery milk scheme in each of the last three years.

Anne Milton: In 2009-10, the number of portions funded was 218 million. In 2010-11 it was 262 million, and in 2011-12 it was 271 million. Of course, children do not necessarily attend nursery five days a week, so the number of portions does not equate to the number of children, so, say, 1 million children attending full- time or 2 million attending 2.5 days a week.

Diana Johnson: In Hull the nursery milk scheme has never been more needed, at a time when poverty is increasing and food banks are expanding. Will the Minister guarantee that no child who currently receives nursery school milk will lose out after the results of the consultation have been published?

Anne Milton: As the hon. Lady will know, we are consulting on a range of options to modernise the operation of the scheme. The cost rose to £53 million in 2010-11, and is due to rise to about £67 million in 2012-13. Given those massive increases, we need to look at the scheme’s operation to ensure that we are getting good value for money.

Lisa Nandy: Does the Minister accept that the cost may well have risen because more children are receiving free milk? Because the consultation is being launched during the school holidays, it will be extremely difficult for schools to respond. If this is a genuine consultation which aims to ensure that milk
	reaches the children who need it, will the Minister consider extending the deadline into September and October?

Anne Milton: The consultation has been running for some time now, and I should have thought that local authorities in particular would have had plenty of time in which to respond. Given that 8,962 settings are paying more than 90p for a pint, which is an outrageous amount, it is extremely important for us to hear from everyone. If the hon. Lady feels that there has been any problem with responses to the consultation and would like to drop me a line, I shall be happy to respond.

Health Inequalities

Mark Menzies: What steps he is taking to reduce health inequalities.

Andrew Lansley: The Health and Social Care Act 2012 established the first legal duties to reduce health inequalities for national health service commissioners and for the Secretary of State. Both the NHS and public health outcomes frameworks will have a strong focus on reducing inequalities in access to health services, and on inequalities in the health outcomes of the population as a whole.

Mark Menzies: My right hon. Friend will be aware of the inequalities in diagnoses of dementia around the country. What steps has he taken to reduce that variation in diagnosis rates?

Andrew Lansley: As I think my hon. Friend will know from recently published data, some of the pilot work involving general practices demonstrated that it was possible to increase substantially the number of patients diagnosed with dementia. I believe that during the pilot period there was an increase of two thirds, more than 60%, in the number diagnosed. As part of the Prime Minister’s dementia challenge, we are using quality incentives in the NHS to identify and refer patients who are admitted to hospital with potential dementia in order to improve their diagnosis and treatment. We hope that that and other measures will identify more of those whose dementia is at an early stage, and will also assist their treatment.

Derek Twigg: One of the key elements in the tackling of inequality is funding. The funds allocated to the clinical commissioning groups was set out in the operating framework, which related to GPs’ patient lists. It has now been changed to take account of data from the Office for National Statistics. Will the Secretary of State assure me that deprived areas will not lose out on the funds allocated to CCGs—not the per-head funds, but the funds allocated to CCGs as a result of the change?

Andrew Lansley: As I am sure the hon. Gentleman knows, we will publish the allocations for 2013-14 later this year. However, we are ensuring, I think rightly, that the allocations to clinical commissioning groups for NHS services reflect the population, because they have a responsibility for the whole population. Some parts of
	the country, particularly London, have substantial unregistered populations, which often include the groups who are most at risk.

David Tredinnick: Does my right hon. Friend agree that one of his important initiatives that could reduce health inequalities is the development of personal care budgets, which give real power and choices to patients, and also have the potential to reduce hospital admissions and costs?

Andrew Lansley: Yes, since the election we have pushed forward with offering access to a personal care budget to those who are in receipt of care and support. At the time of the last election, about 168,000 people were exercising that right. The figure now is over 432,000, and we are extending the scheme so that, for example, people in receipt of continuing health care through the NHS will not lose the opportunity for personal care when the NHS takes over that responsibility; instead, that will continue as a personal budget under the NHS.

Gareth Thomas: Does the Secretary of State think any of the steps he set out in his original answer will lead to a repeat of the shock rise in the number of cancelled operations in the local hospitals serving my constituents, the figures for which were recently set out in a written answer to me by his Minister of State, the right hon. Member for Chelmsford (Mr Burns)?

Andrew Lansley: The number of cancelled operations rises at certain times during the winter, and it did so during last winter. We are clear about the necessity of ensuring that patients do not have cancelled operations if we can avoid that, and, in particular, that those whose operations are cancelled have access to treatment rapidly thereafter. The key is to make sure, as we have done, that patients have timely access to treatment under the referral to treatment times guidelines, and as the hon. Gentleman will be aware, the average waiting time for treatment in the NHS has fallen since the election, as has the number of people waiting a long time for treatment. That is the strongest measure for ensuring all patients get timely to access to care.

Wythenshawe Hospital A and E

Paul Goggins: How many patients attended the accident and emergency department at Wythenshawe hospital in the last 12 months for which figures are available.

Simon Burns: The Department does not collect data on accident and emergency attendances at hospital level. These data are only available at trust level. In the 12 months up to 8 July 2012, there were 108,393 accident and emergency attendances at University Hospital of South Manchester NHS Foundation Trust.

Paul Goggins: I am grateful to the Minister for that reply, and I am sure he will want to join me in thanking the staff at Wythenshawe A and E department, particularly given that that colossal number of 108,000 attendances has taken place in a unit originally designed for 70,000 patients. However, if the A and E department at Trafford
	general hospital is closed, as is currently proposed, that would lead to a still greater increase in the number of patients at Wythenshawe A and E. Given that, is it not essential that the £11.5 million that will be required for extra facilities at Wythenshawe should be made available?

Simon Burns: I hope the right hon. Gentleman is not disappointed, but I cannot add anything to the answer I gave in the debate we had last week when he asked that specific question. I can assure him, however, that local commissioners have assessed the impact of the proposed changes at the Trafford and other hospitals, including Wythenshawe. The plans are still at an early stage and are yet to go to public consultation, and I have been informed that local commissioners will continue to review the impact of these changes on the other hospitals, including Wythenshawe. I urge the right hon. Gentleman, other Members whose constituencies are in the area and their constituents to contribute fully to the consultation process.

Kate Green: The Minister knows that the proposal is, first, to reduce services at the Trafford to urgent care provision and then, within not less than two to three years, to a minor injuries unit. What processes will be put in place to ensure that the most stringent criteria are applied in respect of investment in Wythenshawe and the other hospitals, as well as in Trafford community services and improved services to patients, before any such further move is contemplated,?

Simon Burns: As the hon. Lady will be aware from the debate we had last week, these proposals are subject to the consultation process and to consideration of the results. Commissioners fully recognise the need to minimise the impact the changes will have on neighbouring A and E departments and other services. The Trafford and South Manchester clinical commissioning groups are working on developing further integrated care services, and on developing community care services as an alternative to hospital care, as well as on ensuring that the final decisions meet the needs of the local health economy by providing first-class quality care for the people of that area.

Jamie Reed: Of course, it is not just Wythenshawe A and E that is facing difficulties. All Members throughout the House are grateful for the work our medical professionals do in extremely trying circumstances, but the truth is that the Government’s chaotic reorganisation has resulted in longer waits in accident and emergency. The Minister of State said that last night that A and E departments were meeting the target, but figures published by his Department last week show that the Government have failed to meet the 95% target across major type 1 A and E units. If he cannot get his own figures right, he cannot expect to command the trust of patients or medical professionals. Will he now take this opportunity to show some respect for this House, for the public and for patients in general, and correct the record?

Mr Speaker: Order. May I just explain that the Minister did not widen the parameters of the exchange and therefore they should not be widened, so he is perfectly within his rights, if he wishes, to focus his reply on Wythenshawe. I hope he is not going to be too disappointed. We’ll give it a go.

Simon Burns: I am most grateful for your protection, Mr Speaker.

Mr Speaker: I thought it might be helpful!

Simon Burns: I am most grateful.
	Of course, the hon. Gentleman is playing with the figures. As he knows from previous discussions, he is talking about the SITREP—situation report—figures, which do not form the basis of the figures the Government use. [ Interruption. ] If he will keep quiet for a minute and listen, I will reiterate the point I made last night. Regarding A and E waits of under four hours and the percentile of 95, we are at 96%, which means we are within and above the level set down by the Government’s figures.

Health Allocation Formula

David Mowat: What plans he has to review the health allocation formula.

Andrew Lansley: The independent Advisory Committee on Resource Allocation is reviewing the allocation of resources for the NHS through clinical commissioning groups, and for local authorities in relation to their future public health responsibilities. ACRA’s interim recommendations on the preferred distribution of public health resources were published on 14 June. The NHS formula will be published in due course. The draft mandate for the NHS Commissioning Board makes it clear that it should provide resources to secure equal access for equal need.

David Mowat: I thank the Secretary of State for that answer. It is becoming increasingly clear that ageing is a key driver of health care costs, yet the ACRA formula currently does not properly take that into account, to the detriment of towns such as Warrington. Can he confirm that under the new formula, ageing will be more prominent?

Andrew Lansley: Yes. As my hon. Friend will know, under the existing formula, age was the single biggest factor, but what is important is that the formula accurately reflects the factors that will give rise to need for health care, so that the allocation of resources can respond directly to that need. Ensuring separately that there is an allocation to local authorities for public health, which will be measured in relation to mortality below the age of 75 in particular, will enable those resources separately to be focused on, for example, areas of greatest deprivation which give rise to the poorest health outcomes.

Jenny Chapman: I am interested to hear the Secretary of State say that he understands there is a link between deprivation and health inequality, in light of the new funding arrangements that seem to indicate that councils in the north-east will receive £17 per head less for public health, whereas councils in wealthier parts of the country will receive £8 per head more.

Andrew Lansley: The hon. Lady knows perfectly well that I have said many times that deprivation can give rise to inequalities in health outcomes. In particular, we are
	improving substantially the framework for reducing those health inequalities, because we are giving local authorities specific, dedicated resources. Let me make it clear to her that under the public health allocation formula that I outlined just a few weeks ago, no part of the country will see any reduction in its public health resources from the baseline established.

Residential Care (Funding)

Julie Hilling: What assessment he has made of the effect on residential care providers of reductions in local authorities’ budgets.

Paul Burstow: Local authorities choose how best to use their funding; however, the levels of residential care provision are not determined solely by local council social care budgets. The supply of care home places is governed principally by demand from both public commissioners, such as local councils and the NHS, and private purchasers of services.

Julie Hilling: Nine out of 10 residential home providers say that low council fees are creating a two-tier system, as new investment is directed at wealthier areas where there are more people who can self-fund, and 82% of those providers say that self-funders are being charged more to cross-subsidise local authority-funded residents. This clearly is not fair, so what is the Minister going to do to rectify the situation?

Paul Burstow: We know from the most recent survey published by Laing and Buisson that there has been a 1.4% increase in the fees paid this year, compared with no increase last year. We also know that there is a surplus of places, which accounts for about 10% of the total number of bed places available in care homes up and down the country. So there is actually space, and it is entirely appropriate for local authorities to negotiate appropriate prices to provide good-quality care from one locality to another.

Anne McIntosh: Following the census announcement yesterday that there are elderly hot spots, including North Yorkshire, will this is be a good opportunity for the Minister and the Government to review health and social care funding to reflect a growing elderly population in sparsely populated, isolated rural areas such as North Yorkshire?

Paul Burstow: My hon. Friend is absolutely right to highlight those issues and the emerging findings from the survey. It is important to say that data will be a key consideration in how the next spending review is shaped, along with the priorities that the Government will give to different demographic pressures as a result.

Children's Heart Services

Virendra Sharma: What recent representations he has received on the reconfiguration of children's heart services.

Simon Burns: I have received representations about the review of children’s heart services via letters, parliamentary
	questions and e-mails from hon. Members, via letters and e-mails from organisations and the public, and via meetings. My right hon. Friend the Secretary of State has received two overview scrutiny committee referrals, one from the Yorkshire and Humber joint health and overview scrutiny committee and one from the royal borough of Kensington and Chelsea.

Virendra Sharma: Is the Secretary of State confident that the committee has properly balanced the clinical decisions with the practical transport issues faced by families of children with heart problems?

Simon Burns: The assurance I can give the hon. Gentleman is that we certainly believe so, but these are matters for the joint committee of primary care trusts, which carried out this review. As he will appreciate, it is totally independent from the Department of Health, and rightly so.

Stuart Andrew: My right hon. Friend will be aware of the concerns in Yorkshire about the review. Can he confirm to us, for the sake of absolute clarity, with whom this decision will lie finally?

Simon Burns: I am very grateful to my hon. Friend; this is the hors d’oeuvre before the main meal later today. Ultimately, if any overview and scrutiny committees of relevant local authorities do not agree with the final decisions, they have a right to write to my right hon. Friend the Secretary of State asking him to refer the matter, with their concerns, to the Independent Reconfiguration Panel. If it is asked to look into the matter, it will then come to a conclusion, of which it will inform my right hon. Friend and he will then take a decision.

Greg Mulholland: The Scottish Government have decided that although the Yorkhill unit is currently unsafe, it can be made safe in the context of three surgeons doing 300 operations, whereas the “Safe and Sustainable” review, which is increasingly discredited, is demanding 400 to 500 operations. Why is it one rule for children in Scotland and another for children in Yorkshire?

Simon Burns: I have to tell the hon. Gentleman that the decisions that the Scottish Government and the Scottish Health Department might take with regard to Glasgow is a matter for them. The fact is that we recognise what is commonly accepted among the international community: that the safest way of providing that surgery is by carrying out about 400 operations a year.

NHS (Whistleblowers)

Stephen Phillips: What steps his Department is taking to ensure that confidentiality agreements do not discourage NHS whistleblowers from coming forward.

Anne Milton: The Department wrote to the NHS trusts most recently in January 2012 reminding them that compromise agreements should not prevent information from being disclosed in the public interest. It also said that they should satisfy themselves that their organisational policies are in line with previously issued guidance.

Stephen Phillips: I am grateful to my hon. Friend for that answer. She will be aware of the case of my constituent Mr Gary Walker, the former chief executive of United Lincolnshire Hospitals NHS Trust, who has been prevented by a confidentiality agreement from raising his concerns about the effect on patient safety of the previous Government’s targets. I want to hear Mr Walker’s concerns and my constituents are entitled to hear them. I hope that my right hon. Friend the Secretary of State will look into this matter and give a categorical assurance that the concerns that Mr Walker has told us about will come into the public domain.

Anne Milton: I thank my hon. and learned Friend for his supplementary question. I cannot comment on the individual details of the case, but I appreciate my hon. Friend’s concern that NHS staff could be prevented from speaking out by confidentiality agreements. Confidentiality and compromise agreements are allowed in contracts, but the Public Interest Disclosure Act 1998 provides that any clause in that contract or compromise agreement between employer and employee is void in so far as it acts to stop the employee making a protected disclosure.

Meg Hillier: Given the proliferation of new bodies being created to deliver NHS services, including a number of private sector organisations, can the Minister be confident that the NHS constitution protects whistleblowers working for private companies but delivering NHS public services?

Anne Milton: I assure the hon. Lady that all must have regard to the NHS constitution. In fact, we issued guidance to NHS organisations that all contracts of employment should cover whistleblowing rights. In September 2010, we amended terms and conditions of service and guidance to the NHS on supporting and taking action on concerns raised by staff. The changes made to the NHS constitution make very clear the rights and responsibilities of NHS staff and their employers in respect of whistleblowing. As I have pointed out, all those providing services on behalf of the NHS must have due regard to the NHS constitution.

Topical Questions

Laura Sandys: If he will make a statement on his departmental responsibilities.

Andrew Lansley: My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.

Laura Sandys: I thank the Secretary of State for that answer. Two of my local dentists have been closed as a result of an Office of Fair Trading investigation. Although that is totally understandable and nothing to do with the NHS, will the Secretary of State confirm to my constituents that they will have access to NHS-funded
	dentists? There happen to be more NHS-funded dentists in this country now than there were under the previous Government.

Andrew Lansley: I think I can give my hon. Friend that reassurance. We are committed to increasing access to NHS dentistry, and over 1.1 million more patients have been seen by an NHS dentist since May 2010 than before the election. Nationally, there are more dentists. In 2010-11, there were 22,799 compared with 22,003 in the preceding year, before the election. NHS Kent and Medway has confirmed that it will have six dentists in place from 1 September 2012 who will temporarily provide the treatment that she is looking for, and it has started tendering processes to commission permanent NHS dental services in her area.

Chris Ruane: The Minister will be aware of the 500% increase in the use of antidepressants over the past 20 years. I welcome the announcement of the hundreds of millions that will be spent on talking therapies over the next few years, but will the Minister tell us specifically what funding has been allocated for mindfulness, which is the best known treatment for repeat episode depression?

Paul Burstow: I am grateful to the hon. Gentleman for that question. He has been a doughty campaigner and pursuer of this issue and I can tell him that a number of improving access to psychological therapies—IAPT—services are developing and using mindfulness-based approaches. Indeed, as the hon. Gentleman said, NICE recommends them for the treatment of recurrent depression. A number of randomised controlled trials are going on to see how it might be applied to other long-term health conditions. There is baseline allocated funding but there is no specific earmarked funding for this particular project other than in the context of the IAPT programme, in which we have invested £400 million.

Mark Lancaster: Yesterday’s figures showed a 17% increase in the population of Milton Keynes over the past 10 years, the highest outside London or Manchester, and an unexpected increase of some 4,000 over the estimate in the past 12 months. May I seek the Secretary of State’s reassurance that that will be reflected in future health care budgets for the city?

Andrew Lansley: As my hon. Friend will, I hope, have understood from previous exchanges, the focus on the delivery of care to the resident population in an area covered by a clinical commissioning group will mean that we try, as far as possible, to align resources with the needs of a whole population rather than with just the practice-registered population.

Jonathan Reynolds: The Government often talk about reducing the number of managers in the health service to defend the front line, but following my recent meeting with my local representative from the Royal College of Nursing, can the Secretary of State confirm that under the Government’s definition a ward sister at band 7, who has a hugely important front-line role, is actually considered a manager?

Andrew Lansley: If a member of staff is professionally qualified, they will be counted against the number of managers part of the overall work force census. It remains true, as we have said, that since the election we have reduced the number of managers in the NHS by more than 6,000 and increased the number of clinical staff by more than 4,000.

Duncan Hames: Last year’s National Audit Office report highlighted inconsistencies in the care of patients with neurological conditions such as Parkinson’s, which neurology networks could address. When will the Government publish their review, announced last September, of clinical networks in the national health service, and will it offer any hope for Parkinson’s patients?

Paul Burstow: I am grateful to my hon. Friend for asking that question. The NHS Commissioning Board is currently conducting a review of the effectiveness of clinical networks, and the scope for expanding them. It includes examining the case for neurological clinical networks, and a report should be published very soon.

Kerry McCarthy: In yesterday’s debate, when talking about the south-west consortium, the Minister of State, the right hon. Member for Chelmsford (Mr Burns) emphasised the need for negotiations and agreement with staff. Does the Secretary of State not think it was shocking that staff found out only through a series of freedom of information requests that the consortium existed, and can he tell me when the Department of Health first found out about the consortium?

Andrew Lansley: I will gladly write to the hon. Lady about when we were first aware of the consortium. I think it was several weeks ago; indeed, the document referred to prominently in the press on Sunday had been on websites for some weeks, so there is nothing new about that. We knew about it. I reiterate the point that I and my right hon. Friend made yesterday: even though under a Labour Government, in the 2006 legislation, powers were given to trusts to take their own decisions on the employment of staff, they must do so in negotiation with the staff side. We would expect that. From my point of view, the South West Pay Consortium is rightly looking to maximise flexibility, but I have made it clear to the pay review body that we believe that the flexibility it needs can be delivered through negotiations and “Agenda for Change”. It will not and should not require the reduction of pay for staff.

Tom Brake: The clinician-led “Better Services Better Value” review has condemned the accident and emergency unit, and the maternity and children’s wards at St Helier hospital, because it expects out-of-hospital services to be expanded instead. Will the Secretary of State meet me to discuss local concerns that the £5 million allocated to provide the out-of-hospital services will be totally inadequate to the task?

Simon Burns: I am grateful to the right hon. Gentleman for that question. As he knows, any proposals for service changes will be subject to the Secretary of State’s four
	tests and a full three-month public consultation across south-west London, which I am sure the right hon. Gentleman and his constituents will take part in. My right hon. Friend the Secretary of State will be more than happy to meet him to discuss the matter further.

Mary Glindon: In the north-east region, there is one neuromuscular care adviser providing dedicated specialist care and support for more than 3,000 people with muscular dystrophy and associated conditions. Will the Minister give assurances that care advisers will continue to be funded and commissioned at specialist NHS Commissioning Board level so that they can carry on supporting community teams across the country?

Simon Burns: I give the hon. Lady that assurance. Specialised commissioning will be carried out through the NHS Commissioning Board.

Mary Macleod: I commend the Government for their plans to improve the care and support system, especially for an ageing population. How will the changes make a real difference to carers, particularly those supporting people with Alzheimer’s and dementia? Is there more we can do to support them?

Paul Burstow: I am grateful to the hon. Lady for her question. She is right: we have to do as much as we possibly can to recognise and support family carers. In the White Paper, we have set out a number of steps, not least investment of £400 million to fund more breaks for carers. We are working with the Royal College of General Practitioners to make sure that they are more aware of carers and can identify more carers. We are doing work to make sure we have earlier, quicker diagnosis in more areas of dementia so that people get the support they need. Most important of all, we are making sure that hospitals, as part of the services they provide for people with dementia, actually deliver on NICE guidance on supporting family members. Finally, the Government are legislating, for the first time ever, on support for the needs of carers.

Andrew Miller: What assessment has the Secretary of State made of the views of clinicians, and scientists from academia, industry and the third sector, on the impact of change on the development of stratified medicines?

Andrew Lansley: I have the benefit of a review undertaken by Sir John Bell and his colleagues, which I accepted wholeheartedly. In particular, I immediately agreed with the recommendations, and we are implementing and funding recommendations for the establishment of centres across the NHS for genetic testing to support stratified medicine for cancer patients.

Andrew George: Further to the Secretary of State’s welcome response to the hon. Member for Bristol East (Kerry McCarthy), and his comments yesterday on the issue of the south-west consortium in relation to pay reductions, will he apply the same attitude to pay and conditions, particularly backward or downward regradings and other detrimental changes to terms and conditions?

Andrew Lansley: As my hon. Friend knows, trusts and NHS employers are responsible for the terms and conditions of their staff, and for ensuring, as “Agenda for Change” intends to, that staff who effectively have the same knowledge and competences have the same pay banding, wherever they happen to be across the country. That is the objective of “Agenda for Change”. As I said yesterday, and will continue to say, “Agenda for Change” can be improved—we made that clear to the pay review body—but we think it is possible, if the staff side works with us, to enhance “Agenda for Change” and increase its flexibilities, so that NHS employers can recruit, retain and motivate their staff, with local flexibility, in a national pay framework.

Nick Smith: Given that every year, 1.2 million admissions to accident and emergency units are alcohol-fuelled, when will the Government help the NHS and legislate for a minimum alcohol unit price?

Anne Milton: I am sure that the hon. Gentleman is very familiar with the alcohol strategy and has read it in detail. It is one of the things that we need to do. Brief interventions, specialised treatment, the NHS alcohol check and, of course, changes to licensing will all make a difference. As I say, the alcohol strategy, a cross-Government document, is out. We will respond further in due course.

Sarah Newton: Last week, the Royal Cornwall Hospitals NHS Trust cleared an important milestone towards becoming a foundation trust. An historical debt remains, largely as a result of punitive accounting measures under Gordon Brown. Will my right hon. Friend the Secretary of State do everything that he can to ensure that when the Royal Cornwall becomes a foundation trust, it is debt-free?

Mr Speaker: I think the hon. Lady was referring to the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown). For future reference, we do not refer to Members of the House by name.

Andrew Lansley: My hon. Friend will, I am sure, know that an application for foundation trust status from the Royal Cornwall Hospitals NHS Trust is currently being considered by my Department. The trust is being assessed on whether it meets the quality, service, performance, business strategy, finance and governance standards required if a trust is to be an FT. Once the trust has demonstrated that it has met those standards in all other regards, the Department will ensure that any outstanding liquidity issues are resolved in time for the trust to be authorised as an FT. The process of assessing FT applications will ensure that any remaining debt carried by the trust when it becomes a foundation trust is affordable within the trust’s forward plans.

Clive Efford: The chair of the South London Healthcare NHS Trust has written to the Secretary of State to correct inaccurate information given out by the Department of Health regarding the trust’s performance. [Interruption.] Instead of barracking me, would the Secretary of State—[Interruption.] Instead of shouting at me now, it is a shame that the Secretary of State did not meet the local MPs when he had the opportunity.
	Will he distance himself from the false information put out by unattributable sources in his Department, which will undermine the performance of the hospital and shows little respect for the health service workers who are working to improve services?

Simon Burns: If I can calm the situation down. [ Interruption. ] If the hon. Gentleman will just hush I will give him the answer.

Mr Speaker: Order. There is, frankly, too much noise on both sides of the House. It does not suit the Minister now for the hon. Member for Eltham (Clive Efford) to shout from a sedentary position, and I absolutely understand, similarly, that it does not suit Opposition Members when the right hon. Gentleman and his colleagues chunter from a sedentary position. Let us have a truce, and the right hon. Gentleman can be a statesman—we look forward to it.

Simon Burns: As ever. I do not share the hon. Gentleman’s analysis of the interpretation of what has happened with regard to the trust’s performance. There has been an historic problem with its performance, but I pay tribute to the staff, who have made tremendous efforts to improve performance, and have achieved some improvement. The trouble is that it is not sustainable not to put the trust on a sustainable financial footing. The hon. Gentleman said that he would like a meeting with me or my right hon. Friend the Secretary of State. [ Interruption. ] As he will know, if he keeps quiet for a minute, I have written to him offering a meeting with my right hon. Friend, on 24 July; I hope that the hon. Gentleman can attend.

Zac Goldsmith: Cases of blood poisoning from E. coli have increased by nearly 400% in the past 20 years, and E. coli resistance to antibiotics is almost certainly linked to record levels of antibiotic usage on factory farms. By over-using antibiotics we risk ruining for future generations one of the great discoveries of our species. Will the Department put pressure on the Department for Environment, Food and Rural Affairs finally to take that issue seriously?

Andrew Lansley: I understand the issues. Indeed, I was interested to see analysis some years ago of the extent of antibiotic resistance in hospitals in the Netherlands. Resistance was clearly much more prevalent in parts of Friesland where there was much greater antibiotic usage in farming. I therefore completely understand, and my colleagues in DEFRA understand this too. Just as we are looking for the responsible and appropriate prescribing of antibiotics in the health service, my colleagues feel strongly about the proper use of antibiotics in farming.

Mark Durkan: When the national advisory council of the Thalidomide Trust recently met Government representatives, no funding undertakings were available on the replacement of the health support grant for sufferers. When can we expect a meaningful commitment in that regard, and is the Department liaising with its devolved counterparts?

Paul Burstow: Yes, we are liaising with the devolved Administrations. Yes, we had a productive meeting with the trust and the council, which confirmed that they will
	shortly submit to us the second-year evaluation of the pilot programme. I undertook to look at that carefully and enter into further discussions with a view to reaching a conclusion and making further announcements this autumn.

Julian Lewis: Ministers may recall the concern of patients and carers in the New Forest area about the decision to close a third of acute adult mental health beds in Hampshire. Are Ministers aware of a similar trend in other parts of the country, and if they are, as they should be, what do they think about it?

Simon Burns: My hon. Friend has raised that issue in different forms on many occasions, and feels strongly about it. The decision to reconfigure services in his constituency was made locally, and the Hampshire overview and scrutiny committee decided not to write to my right hon. Friend the Secretary of State asking him to refer it to the Independent Reconfiguration Panel, because it presumably believes that it is the right way forward to continue to provide first-class quality care for patients.

John Woodcock: Does the Secretary of State agree that commissioners in Cumbria must bear their share of responsibility for the
	deep-seated problems in the Morecambe Bay health trust, which have taken far too long to address. Will he join me in urging those commissioners to protect services such as Barrow’s maternity unit in their forthcoming review?

Andrew Lansley: As we have seen in a number of instances over the years in the NHS, all those responsible should always be aware that, although the responsibility for quality may be, in the first instance, for the board of a trust, it is also the responsibility of those who commission the services. As the hon. Gentleman will be aware, one of the key considerations for the future in the development of services is for the NHS to respond to the commissioning intentions of local commissioners. Clearly, the matter that he raised will be determined locally as regards what commissioners require in terms of services from Morecambe Bay trust.

Several hon. Members: rose —

Mr Speaker: Order. I am grateful to Ministers and all colleagues, but as usual, demand has exceeded supply. I am sorry to disappoint some colleagues but we must now move on.

Defence Equipment and Support

Mr Speaker: Before I call Alison Seabeck to ask the urgent question, it may be for the convenience of the House if I make it clear from the outset that I intend to conclude supplementary questioning no later than half an hour after the start of the UQ. Brevity by all concerned should enable all those who wish to contribute to do so.

Alison Seabeck: (Urgent Question): To ask the Secretary of State to make a statement on the future of Defence Equipment and Support.

Nick Harvey: A key element in the transformation process under way in the Ministry of Defence is that of its equipment and support activities through the matériel strategy. Reforming the acquisition system to drive better value from the defence budget is a core element of the process. This will require changes to Defence Equipment and Support to ensure that the organisation has the structures, management and skills it needs to provide the right equipment to our armed forces at the right time and at the right cost. Change is essential to tackle the legacy problems in defence acquisition that have historically led to cost and schedule overruns and have resisted previous attempts at reform.
	The current system does not help or support DE&S properly, and it is not delivering value for money for the taxpayer. Bernard Gray’s analysis reveals the following root causes: first, an historically overheated equipment programme in which far more projects were planned than could be paid for; secondly, a weak interface between DE&S and the wider Ministry of Defence, with poor discipline and change control between those setting requirements for equipment and those delivering the programmes; and, thirdly, insufficient levels of business capability at DE&S for the scale and complexity of the portfolio it is asked to deliver. The result of these combined issues has been significant additional costs in the defence budget in the order of hundreds of millions of pounds each year.
	Earlier this year, MOD officials were asked to focus their efforts on considering the comparative benefits that could be derived from changing DE&S into an Executive non-departmental public body with a strategic partner from the private sector or a Government-owned, contractor-operated entity. The work done to date suggests that the strategic case for the GOCO option is stronger than that for the ENDPB option. Further value-for-money work is under way to confirm this assessment. In the meantime, as resources and commercial appetite constrain our ability to pursue these two options simultaneously to the next stage, we have decided that the Department should focus its effort on further developing and testing the GOCO option.
	The work to determine value for money between the options will take place over the next few months. In parallel, we will begin to develop a commercial strategy, engaging with industry to hone our requirement. This work will support decisions later this year on whether to proceed with the GOCO option and whether to launch a competition for a private sector management company
	to run the organisation. Provided that the further work demonstrates that the value-for-money case for GOCO over ENDPB is conclusive, this will be followed by an investment appraisal that will test the GOCO against a public sector comparator. Ultimately, this would be followed by a decision on whether to proceed.

Alison Seabeck: Let me be clear that there is massive consensus across this House that defence procurement must be tackled to ensure that some of the issues that plagued successive Governments are not repeated. We understand the budgetary challenges faced by the MOD and agree that procurement reform is essential to ensure financial sustainability.
	It was therefore a huge surprise when yesterday the Secretary of State revealed in Defence questions that a decision had been made on the future of DE&S, but that no oral statement was planned and, indeed, that it was to be slipped out on the last day of Parliament. It was a bigger surprise, therefore, to read in the written statement that in their third year of government, no decision has yet been made by Ministers. The delay is as worrying as it is inexplicable. With the Gray review, the previous Government began the process of reform. It is now unclear when it will be completed. Will the Minister comment on the timing and confirm that primary legislation will be required for a GOCO?
	The Government prefer the Government-owned, contractor-operated model, but it is unclear why. Will the Minister explain precisely why a GOCO is preferable to an NDPB? Are his Treasury colleagues content that the GOCO model offers value for money? Will he make a commitment to publish the full reasoning for the rejection of other models?
	We fear that privatisation could weaken the public accountability and transparency of multi-billion-pound defence decision making. How would a GOCO be held publicly accountable? Who would be responsible for ensuring that contracts were delivered to time and to cost? We have seen recently with G4S that outsourcing does not guarantee efficiency or effectiveness, and can increase risk. Indeed, even with the London Organising Committee of the Olympic Games and Paralympic Games model, problems have arisen because Ministers have been distanced from the decision-making process and the lines of responsibility have been blurred. Such issues would be unacceptable when dealing with our armed forces.
	Will the Minister say what will happen to existing contracts under the GOCO model? Crucially, those include the nuclear deterrent. Finally, what will the military’s role be in procurement under these plans? What guarantee can he give to the 20,000 people who are employed by DE&S that their jobs are not under threat?
	The future of DE&S is not only about tens of thousands of highly skilled jobs in our defence industry, but, crucially, about the security of our nation. Getting it wrong would put lives at risk. It is vital that Parliament has a full opportunity to scrutinise these decisions.

Nick Harvey: May I correct the hon. Lady’s first proposition? It is clear that no decision has been made. A study is being carried out, which involves value-for-money work. If, when that appraisal is completed, we take this option forward, that is the point at which the decision
	will be made. Only when the model had been worked up and thoroughly tested would we finally take the decision to go ahead. Of course, we would come back to the House at that point.
	The hon. Lady suggested that we had slipped this announcement out. I would say that the contrary is true. If the House had not been about to go into several weeks of recess, we would not necessarily have made a statement yet. We have done so to give the House the greatest possible transparency about what is going on and to send the clearest possible signal to the potential commercial partners that we are serious about this matter and are taking it forward. I stress that the decision about timings will be taken towards the end of this year. The commercial partner would be sought in a competition during the course of next year and a decision on whether to go ahead would be taken early in 2014.
	The hon. Lady asked whether this model would include the nuclear component of defence. I remind her that the Atomic Weapons Establishment at Aldermaston is a Government-owned, contractor-operated organisation, and that it works extremely well. The last Labour Government and previous Governments have made extensive use of the private sector in providing critical elements of our defence and other public services. I see no reason to believe that it would be any less capable of doing so in this area.
	The GOCO option has looked better in the early explorations because if we stuck with an ENDPB, the work force and the management would remain in the public sector, and the greatest possible private sector involvement would be the use of a consultant. If we go for the GOCO option, the entity will have all the freedoms of a private sector operator: it will recruit people on private sector terms and conditions, and will have an incentive to make the thing work in a way that an ENDPB would not.

James Arbuthnot: Does my hon. Friend agree that this is a matter of such crucial importance that it is important that it should not become a party political plaything, and if it can be done in such a way as to attract the support of all sides of the House, the benefits that will flow from these changes will come sooner and they will flow much more copiously, and we will reach the sunlit uplands of wonderful defence procurement?

Nick Harvey: I strongly agree with my right hon. Friend. It is worth recalling that the previous Government asked Bernard Gray, a former Labour special adviser at the Ministry of Defence, to conduct his study of defence procurement. He came forward with a compelling and, to some extent, damning report. Central among his recommendations was the proposition that there should be a GOCO to run DE&S in the future.
	We have now recruited Bernard Gray to be the Chief of Defence Matériel and given him the opportunity go into further depth, and it has become increasingly clear that he was absolutely right. Of course these issues will have to be debated, and I have explained that the timelines are still quite long. No decisions have yet been taken, and proper value-for-money studies will continue.
	To answer a question that the hon. Member for Plymouth, Moor View (Alison Seabeck) asked, those studies will be made available for everybody to have a look at. This does not need to be a political football, and I hope it does not become one.

David Crausby: Where will these proposals leave the complex weapons contract, which has delivered such effective outcomes in Libya and provided top-class jobs and technology throughout the country, particularly in north-west England?

Nick Harvey: As far as I am concerned, the proposals will have no impact on that. The specific contracts to provide particular services and products will be unaffected by the changes. They will enable us to secure better value for money in future when we make further contracts on a variety of defence procurement issues.

Mark Lancaster: Urgent operational requirement contracts have played an important part in recent years, but unlike with planned procurement the through-life costs are often not included in the initial costs. How will the through-life costs be accommodated in an overheated defence budget?

Nick Harvey: Decisions on whether any of the procurements that we made under the UOR process should be brought into the core defence programme will have to be taken individually in respect of each procurement. Some will be brought into the core programme, and at that point a full analysis of through-life costs will have to be made. Others, despite having performed well in theatre, will not be brought into the long-term defence programme. The type of scrutiny that my hon. Friend seeks will take place at that point.

Mark Tami: How will this decision, or lack of decision, affect existing contracts such as that for the A400M, on which many UK aerospace jobs rely?

Nick Harvey: It will have no impact on existing contracts. It is the means by which we will secure better value for money in forming future contracts.

Julian Lewis: Can the Minister explain in a practical way how a complex and expensive equipment programme such as the future carriers would have been better carried out under the new arrangements? For example, somewhere along the line the idea that the carriers should be easily convertible to take catapults was left out of the design. Would that situation be improved by the new arrangements?

Nick Harvey: It is probably common ground throughout the House that defence procurement has not been an exemplar of success for a good many years. One reason for that is that despite the good work of good people working for DE&S, they do not have available to them the full range of skill sets that they need to negotiate on equal terms with some of the more complex providers. Granting DE&S the private sector freedoms I have described will enable it to take on board the necessary skill sets to ensure that in future negotiations and future project management there is a better match between those securing value for the taxpayer and good products for the armed forces and the private sector providers of complex programmes. That will be a marked improvement on how things have been in the past.

Jim Shannon: Will the study that the Minister mentioned consider the procurement and purchasing of equipment alongside our allies and other countries, which could reduce costs?

Nick Harvey: It is certainly true that a lot of our procurement is done in a cohort with our allies, and as time goes forward I expect that to be increasingly the case. Having a Government defence equipment and support body with the freedom to operate in a quasi-private sector model will give us the best possible latitude to deal with a variety of allies that have differing models of defence arrangements.

Bob Russell: One of our allies is Australia. I urge the Minister to look to that country, where a Government-owned contractor-operated organisation seems to work successfully. Will he give me a guarantee that this Government, unlike the previous one, who gave away submarine engine orders to Germany, will ensure that contracts are let to British industry?

Nick Harvey: Of course, competition laws dictate the ability of any Government to grant contracts to onshore suppliers. Our first and foremost consideration is to equip the armed forces with what they need. Our second consideration is to ensure value for the taxpayer. If, having ticked both those boxes, it is possible to ensure a healthy and thriving defence industry in the UK, so much the better. We like to give contracts to British suppliers when possible, but there are competition laws and our hands are tied.

Mark Hendrick: The Minister proposes a procurement model that allows the Government to buy off the shelf from any company, whether or not it is British. He will be aware that BAE lost the Typhoon contract and that a French company has preferred-bidder status. If we are not prepared to give preferred-bidder status to British companies, why should other countries do so?

Nick Harvey: Clearly, it would be foolish not to consider buying things off the shelf that meet the requirements of the British armed forces. However, I repeat that clear competition laws determine the circumstances in which we can award preferred-bidder status. In many cases, we are unable to do so.

Bob Stewart: Can the Minister career-plan specialist officers who go into defence procurement, so that they can spend longer than two years—three or four years, perhaps—doing the job to improve the efficiency of the product?

Nick Harvey: My hon. Friend makes a good point. Even under the proposed model, we will continue to have quite a lot of military personnel inside DE&S, which it needs to give it insight into the user requirement. I agree with my hon. Friend that short rotations have not served DE&S well. It would be to the benefit of both the individuals and the organisation if postings were for longer periods.

Ian Murray: Thousands of jobs in Edinburgh rely on companies such as SELEX Galileo. What relationship will the new body have with such private sector companies?

Nick Harvey: The new body will have the same relationship as the existing one with suppliers of such products. The new body will contain a greater degree of private sector expertise, so it might be able to drive a harder bargain.

Penny Mordaunt: We need to make the best use of the defence budget and give our armed forces the tools they need to do the job, but we must also protect sovereign capability and have a strategy on where we invest our research and development budgets. Does the Minister agree that deciding how we organise those two things is too important to be left to dogma?

Nick Harvey: I agree with my hon. Friend that we need to maintain sovereign capabilities. I referred a moment ago to competition law, but when there are specific exemptions that enable us to protect national sovereignty for reasons of national security, we will take them. She is right on the research and technology budgets. They will remain an important part of our work. We cannot leave it entirely to the private sector to undertake primary research. It is necessary for the state to stimulate it.

Sharon Hodgson: The Minister may know that I was present on 2 July at the royal opening of the new £75 million BAE System munitions factory in my constituency. It was built thanks to the innovative, 15-year munitions acquisition supply solution contract signed by the MOD back in 2008, and sustains more than 200 jobs. What will happen with such long-term contracts, which are so important to my constituency?

Nick Harvey: Nobody would suggest that everything that occurred under previous systems was not good. Clearly, there are exemplars—some contracts worked well. I am sure the facility in the hon. Lady’s constituency will be a great success and that it will support employment for many years to come, but the fact that we will have a more private sector-rooted procurement body will not have any negative impact on such contracts.

Tobias Ellwood: The shadow Minister spoke of the budgetary challenges facing all Governments, but was quick to gloss over her legacy—the budget was taken away from the MOD by Labour and given to the Treasury. Does the Minister share my surprise at Labour Members questioning the new avenues of efficiency when, if they looked at the National Audit Office major projects report 2010, they would see that the majority of major projects overran, including the A400M, the Astute and the Typhoon?

Mr Speaker: Order. The question was simply far too long. I do not know why the hon. Gentleman is smirking about it—

Tobias Ellwood: indicated  dissent .

Mr Speaker: Order. He has abused his privilege and ought to learn from it.

Nick Harvey: There have undoubtedly been serious problems with the procurement side of the defence business for a very long time. The deficit in defence from two years ago was in very substantial part caused by the
	overheating of the procurement budget, but we have taken dramatic steps in the past couple of years to get the defence budget back into balance. The Treasury can see the progress we have made, but the steps we are proposing today will not be taken unless it is satisfied by the work on value for money that is currently taking place.

Meg Hillier: As the Minister has acknowledged, there have been long-standing problems in defence procurement. The Public Accounts Committee has taken a keen interest in the matter. Will he outline exactly what steps he is taking to ensure that the establishment of the GOCO model is well worked up, so that we do not have some of the problems that we have had with other procurement bodies in the past?

Nick Harvey: The hon. Lady makes a good point—that is why I was at pains to spell out at the outset that the process has some considerable way to go. Only when the work on value for money is completed will a decision be taken on whether we are going ahead in principle. At that stage, we will work the model up in detail and look for a competition with private sector partners. At the end of all of that, there will be a final testing, which must satisfy the Treasury, among others. That will be the point at which a decision to go forward will be taken. There is a long route to go.

Andrew Murrison: Does the Minister agree that a key indicator of the success of either of the two models that he has described will be the attitude towards small and medium-sized enterprises in defence tendering in instruments such as pre-qualification questionnaires, which are generally unhelpful to SMEs?

Nick Harvey: My hon. Friend makes good points on the difficulties that SMEs believe they currently have in some of our big procurement projects. Since the move to the MOD contracting directly with prime contractors, which then handle subsidiary contracting, it would be true to say that the MOD has rather lost the skill set of managing SMEs. By the time the reforms are complete, I hope that a GOCO of the sort I have described will reinvest in those skill sets and that we will be better able to manage SMEs directly.

John Woodcock: In the light of what the Minister has said on sovereign capabilities, and the fact that Aldermaston is already a
	GOCO, how will the successor deterrent programme be different if it is transferred into a GOCO?

Nick Harvey: There will be very little difference. The fact of the matter, however, is that the project management undertaken on behalf of the MOD by DE&S will—I say this with considerable confidence—be better, because there will be a higher level of skills in DE&S. It will bring in a variety of new commercial skill sets of which it is currently short. That will secure better value for money and more efficient delivery of the contract.

Duncan Hames: I thank the Minister for his openness with the House at this early stage in his considerations. Will he commit to write to Members of the House who represent the DE&S work force as the project progresses, particularly in relation to the protections available to them under TUPE regulations?

Nick Harvey: My hon. Friend makes a good point, and I have been at pains to stress that despite DE&S lacking some of the skills it needs going forward the work done by those who work for it is of a high quality and is much appreciated by the MOD. We are consulting the work force and the trade unions as we take these steps forward, and as part of the ongoing consultation we will be happy to talk to Members representing constituencies where the majority of DE&S staff are based.

Jenny Chapman: For clarity, who in the future do the Government intend to be accountable for failures to deliver contracts on time and on budget?

Nick Harvey: The MOD will be the customer of the organisation and is responsible to Parliament for everything it does. If there is a failure, the buck will stop with the MOD.

Diana Johnson: Is the Minister saying that under this proposal British small and medium-sized enterprises in the defence industry will benefit?

Nick Harvey: I sincerely believe that SMEs in Britain will benefit because, at the moment, they get all their work through prime contractors, and it is a common complaint of SMEs that they do badly out of prime contractors. If we rebuild the skills inside DE&S so that it can manage the supply contracts from SMEs directly—in some instances—they will benefit. That is certainly what SMEs are telling us.

Points of Order

Jamie Reed: On a point of order, Mr Speaker. Yesterday, and again this morning, Health Ministers made a series of inaccurate statements. What powers exist under Standing Orders for you to ask them to return to the House and correct inaccurate figures on NHS budgets, delayed discharges and accident and emergency waiting times?

Mr Speaker: The short answer to the hon. Gentleman’s attempted point of order is that answers to questions are the responsibility of Ministers. Similarly, in the event of an inaccuracy known to the Minister, it is the Minister’s responsibility to correct the record. The hon. Gentleman is a determined and persistent chap, and I feel sure that he will pursue the path of righteousness to his satisfaction. If he remains dissatisfied, no doubt we shall hear from him again.

Diana Johnson: On a point of order, Mr Speaker. In response to a question on 11 July, the Health Secretary told me that local government was being given sufficient funding to cope with provisions in the new social care White Paper, but on the same day the Local Government Association released a statement saying:
	“there won’t be enough money to provide these services to anyone other than the most needy, or those who can afford to pay for all of their own care.”
	In the interests of accuracy, will the Secretary of State correct the record?

Mr Speaker: I am sorry to disappoint the hon. Lady, but in material terms my reply does not differ in content from that which I just offered the hon. Member for Copeland (Mr Reed). It is, at least in part, a matter of interpretation. I said that the hon. Gentleman was a persistent chap, but she is a persistent woman, and I feel sure that she will pursue this matter in a way she judges fit.
	I shall now call the hon. Member for Wellingborough (Mr Bone) to make an application for leave to propose a debate on a specific and important matter that should have urgent consideration under the terms of Standing Order No. 24. The hon. Gentleman has three minutes in which to make such an application.

Wellingborough Prison

Application for emergency debate (Standing Order No. 24 )

Peter Bone: I seek leave to move the Adjournment of the House to discuss a specific and important matter that I believe should have urgent consideration—the loss of up to 600 jobs in my constituency owing to the announcement today of the closure of Her Majesty’s Prison Wellingborough.
	It is with great regret that I move this motion at all. At 9.30 today, I was doing a live broadcast on BBC Radio 5 Live when it was announced as breaking news that Wellingborough prison was to be closed. I was not told in advance and have only just received an e-mail from the Under-Secretary of State for Justice, my hon. Friend the Member for Reigate (Mr Blunt), who has responsibility for prisons, outlining the plans to shut the prison. I hasten to add that this came after I learned about it through the media first.
	That is in total contrast to how the right hon. Member for Blackburn (Mr Straw)handled the situation when Wellingborough prison was put into the market testing programme. On that occasion, the then Justice Secretary rang me at 6 am on the day of the announcement to ensure that I was fully briefed before the public statement. Clearly, the coalition Government believe in making announcements to the media before telling the local constituency MP.
	What is most disturbing about the matter is the number of jobs that will be lost in my constituency. Up to 600 people might lose their employment, whether they are employed directly through the prison or indirectly through local businesses. The independent monitoring board annual report states that the prison improved from a level 2 to a level 3 prison. Wellingborough prison has moved from 123rd out of 130 in the prison rankings to 93 owing to the hard work and commitment of its governor and staff. It has also become far more cost effective, with 5% efficiency savings in 2011-12 and further planned efficiency savings of 3% projected for 2012-13.
	This is a good, improving prison that is now being closed without any consultation or appeal process. Closure would have significant ramifications for my constituents. The prison management and officers have done everything they were asked to do and more. The reason given for its closure is that we have too much space in our prisons. This comes after years and years of being told that they are overcrowded and that we need more spaces—the previous Government allowed prisoners out early because there were not enough spaces.
	There seems to be no consistency within the Ministry of Justice. With Britain’s increasing population, surely to have spaces left in prisons would be a sensible precaution, not least in case we have a repeat of last year’s riots. Hundreds of people losing their jobs in my constituency for a short-term, dubious economic saving is plain wrong. This is the wrong prison being closed for the wrong reasons at the wrong time.

Mr Speaker: I am grateful to the hon. Gentleman for his application under Standing Order No. 24. I understand his extreme disappointment at the decision and the
	alleged handling of the matter and of him. That said, having listened carefully to his application, I must nevertheless conclude that the matter does not, on this occasion, meet the criteria under Standing Order No. 24. Agreeing to the application would, of course, cause the subsequent debates to be significantly delayed. I recognise that my decision will disappoint him, but knowing him, as I do, to be an extraordinarily assiduous parliamentarian, I feel sure that it will not be long before he returns to the matter. I suspect that Justice Ministers are also keenly aware of that fact.

ROYAL ASSENT

Mr Speaker: I have to notify the House, in accordance with the Royal Assent Act 1967, that Her Majesty has signified her Royal Assent to the following Acts:
	Supply and Appropriation (Main Estimates) Act 2012
	Finance Act 2012

Cosmetic Surgery (Minimum Standards)

Motion for leave to bring in a Bill (Standing Order No. 23)

Ann Clwyd: I beg to move,
	That leave be given to bring in a Bill to establish minimum standards for the practice of cosmetic surgery, including non-surgical procedures; and for connected purposes.
	The Bill would establish the regulation of cosmetic surgery. I, too, am persistent, Mr Speaker. I first introduced a ten-minute rule Bill on the regulation of cosmetic surgery in 1994. Unfortunately, despite calls from a wide range of organisations, not much has changed since. As a result, thousands of women have continued to face the horrific consequences of unregulated cosmetic surgery. That ten-minute rule Bill generated huge publicity and hundreds of letters, and the issue of breast implants has received even more attention of late following the PIP implant scandal in 2010.
	At some time in our lives, most of us have wanted to change something about ourselves. Huge pressure is put on women in particular, but increasingly on men too, to change their looks. Private sector clinics offer a multitude of cosmetic procedures to achieve the perfect shape or a wrinkle-free face. Too thin, too fat, never just right—that is the message. Cosmetic surgery, including breast implants, continues to be a growing industry. In 2011, members of the British Association of Aesthetic Plastic Surgeons conducted almost 45,000 surgical procedures, more than 10,000 of which were breast enlargements for women. Between 2002 and 2011, the number of boob jobs rose by 324%, and it continues to rise, as do the numbers of facelifts, tummy tucks and nose jobs.
	Members of the British Association of Aesthetic Plastic Surgeons also operated on more than 4,000 men, with nose jobs and man-boob jobs the two most popular procedures. That represents a 219% increase in cosmetic surgery for men since 2002, and does not include procedures carried out by people who are not members of the association, those undertaken abroad or those not yet classified as cosmetic procedures. Many people face exploitation by private sector clinics and even cowboy surgeons if they are unable to receive treatment through the NHS. Most cases of botched surgery or mistakes are then rectified by the NHS, as we have seen with the removal of PIP implants.
	Regulation is needed in a number of areas to reduce the risks to patients. In 1998, the then Government accepted the recommendation of an independent review body on silicone breast implants to establish a national breast implant registry. I was part of that process and took part in several meetings at the Department of Health, but the register was abandoned in 2006. I propose that we now need a register for all types of implants used in all areas of the body, including breasts, cheeks, pecs and buttocks. That would allow better monitoring of outcomes and problems as they occur, which would have been useful in the recent PIP cases.
	Many clinics gain much of their business from advertising in national newspapers and women’s magazines. They ask, “Is cosmetic surgery only for the rich and famous?” The answer they give is: “Not any more—it’s a lifestyle choice!” Some offer significant discounts, and there are even special deals on websites. Private clinics are now
	advertising on Twitter. One even suggested that women add a boob job to their Christmas present list. Misleading images and claims are used, despite tighter guidelines from the Advertising Standards Authority. Therefore, a ban on cosmetic surgery advertising should be introduced, as happened in France in 2005 and as the British Association of Aesthetic Plastic Surgeons has called for. If cosmetic surgery is considered a form of medical procedure—which it undoubtedly is—it should not be advertised, as is the case with prescription medicines.
	A further concern is non-surgical cosmetic procedures. Injected fillers such as Botox currently need only a CE mark—as do fridges—and are therefore heavily marketed in the UK, while the Food and Drug Administration in the USA categorises them as medical device implants requiring approval. [ Interruption. ] I would be grateful if those on the Government Front Bench listened to the point I am making, because it is a scandal that Ministers have done nothing about the situation.
	The medical profession has always been controlled and regulated by strict ethics, but the voluntary codes of practice have been breached by some operators to make quick, easy money. An independent review found that 70% of clinics in the private cosmetic sector are effectively unregulated and that fewer than half of all operating theatres were properly equipped in 2010. We also need compulsory registration of all those who practise aesthetic medicine and use lasers. Facilities should be licensed and regulated by an independent body, such as the Care Quality Commission. Similarly, only doctors or nurses qualified to do so should be able to advise patients about cosmetic surgery. At the moment, initial consultations can be undertaken by a hard-sell receptionist, and doctors in private practice who lack specific experience can offer treatment which they are simply not qualified to give.
	Somebody wrote to me about her experience of liposculpture in a ground-floor office in Harley street. She said:
	“I think the operating table was a dental chair. They asked me to turn over on to my stomach, but the chair was the wrong shape and it was very difficult. At some stage during the operation I woke up. I was in tremendous pain and began screaming. They were still taking fat from my legs. The doctor told me afterwards that he had to continue with me awake or my legs would have been uneven.”
	It turned out subsequently that the “cosmetic surgeon” was a general practitioner. He had performed a surgical operation without any surgical training and had
	administered a general anaesthetic without an anaesthetist. Such incidents are far too common. I read last week about a children’s writer. She has been left with blurred vision from botched laser eye surgery at a private clinic. After a five-year battle, she has finally received £250,000 in compensation, but has permanent scarring. In the
	Daily Mail
	only last week there was a piece headed, “Plastic surgeons offer buy one get one free on breast enlargements and nose jobs”.
	Given all the issues and the lack of regulation in cosmetic surgery, it seems imperative to establish an official regulator of cosmetic surgery—OfCos, as proposed by the British Association of Aesthetic Plastic Surgeons—to ensure registration and regulation of all cosmetic surgeons and practitioners in the UK. Or perhaps we should consider a cosmetic surgery licensing body that has a different type of structure and operates as a financial guarantee system, like ATOL—air travel organisers licensing—which provides financial protection for flights and air holiday packages.
	The problem has been swept under the carpet for far too long. It is now almost 20 years since I first stood here and called for greater regulation of private cosmetic surgery. The current system of self-regulation by the private surgeons and clinics is clearly not working. As the previous president of the British Association of Aesthetic Plastic Surgeons said in 2009:
	“In no other area of medicine is there such an unregulated mess…Imagine a ‘2-for-1’ advert for general surgery? That way lies madness!”
	This is a complex subject, but too many people are suffering and being disfigured at the hands of cowboys who have been given free rein to abuse the British public’s trust in the voluntary system of medical ethics. The responsibility clearly lies with the Government to take action as soon as possible to stop any more innocent people being subjected to butchery at the hands of some greedy, unscrupulous, and incompetent people, and to introduce the kind of regulation for cosmetic surgery that is long overdue.
	Question put and agreed to.
	Ordered ,
	That Ann Clwyd, Dr Sarah Wollaston, Fiona Mactaggart, Valerie Vaz, Dr Daniel Poulter, Barbara Keeley and Sheila Gilmore present the Bill.
	Ann Clwyd accordingly presented the Bill.
	Bill read the First time; to be read a Second time on Friday 2 November  2012 , and to be printed (Bill 60).

Backbench Business
	 — 
	Prime Minister’s Adviser on Ministers’ Interests

Mr Speaker: Before I call the hon. Member for Harwich and North Essex (Mr Jenkin) to move the motion, I should explain to the House that this is not a vehicle for the utterance of ad hominem attacks on individual right hon. or hon. Members. For the purpose of such attacks or criticism, a substantive motion relating to an individual right hon. or hon. Member would be necessary. The issue here is the principle and the proposal that the hon. Gentleman wishes to put before the House.

Bernard Jenkin: I beg to move,
	That this House calls on the Government to implement the recommendation made by the Public Administration Select Committee in paragraph 44 of its Twenty-second Report of Session 2010-12, The Prime Minister’s Adviser on Ministers’ Interests: independent or not?, that the Independent Adviser on Ministers’ Interests ‘should be empowered to instigate his own investigations’; and notes that this motion has been agreed by the Public Administration Select Committee.
	I am extremely grateful to the Backbench Business Committee for giving the House this brief opportunity to express an opinion on this question today. The Public Administration Select Committee motion is supported by no less than 18 Select Committee Chairmen. The issue turns on a simple question of principle, which is whether or not the Prime Minister’s adviser on Ministers’ interests should be able to decide for him or herself to investigate a potential breach of the ministerial code. All the credible advice that we have received suggests that such a decision should be a matter for the adviser and not for the Prime Minister.
	The Public Administration Select Committee—PASC—has advocated that course of action since the first adviser, Sir John Bourn, was appointed by Tony Blair in March 2006. The ministerial code sets out the circumstances in which the adviser—always referred to as the “independent adviser”—is requested to investigate alleged breaches of the code. Under the present arrangements, the question of whether or not to investigate is therefore in the hands of the Prime Minister of the day, on the advice of the Cabinet Secretary.
	In 2006, in paragraph 17 of PASC’s report entitled “The Ministerial Code: the case for independent investigation”, the Committee warned:
	“It is hard to see how the Independent Adviser can command public confidence if the Prime Minister can decide that prima facie breaches of the Code will not be investigated. Put simply, there is no point in having an investigator in post if he is not given discretion to investigate very public allegations that the Code has been breached.”
	Paragraph 20 of the report points out:
	“The decision to instigate an investigation still lies with the Prime Minister. The Prime Minister is clearly not an impartial figure when it comes to deciding whether or not to instigate an investigation. If the regulatory system is to have credibility, that decision must be taken out of political hands.”
	In paragraph 34 of the report, the Committee therefore concluded:
	“Until the changes we outline have taken place, it is inappropriate to refer to the new investigator as an Independent Adviser.”
	The previous Government refused to accept PASC’s recommendation because they believed that
	“it must ultimately be for the Prime Minister to account to Parliament for his decisions and actions in relation to the appointment of his Ministers”.
	I have to say that that rather missed the point. The Committee was not suggesting that the Prime Minister should cease to make decisions about who to appoint or to dismiss as Ministers, or that he should cease to account to Parliament for those decisions. It merely suggested that he should be supported by truly independent advice.
	PASC’s most recent report on the subject, entitled “The Prime Minister’s adviser on Ministers’ interests: independent or not?” was published this year. In it, we concluded that, because our previous recommendations had not been implemented,
	“the title of ‘independent adviser’ is a misnomer.”
	Paragraph 44 of that report also reiterated PASC’s central recommendation
	“that the independent adviser should be empowered to instigate his own investigations. The Prime Minister could do this on his own initiative, without any need for legislation, but placing the post on a statutory footing would be preferable.”
	The disadvantages of the present arrangements have been manifest in recent months. Sir Philip Mawer, the previous incumbent, expressed his frustration to the Committee that he was given no role in the investigation of the conduct of my right hon. Friend the Member for North Somerset (Dr Fox) in respect of Adam Werritty, and suggested that there needed to be a willingness to engage the adviser earlier in the process of investigating potential breaches of the ministerial code. In that case, the Cabinet Secretary conducted the investigation instead of the adviser. Why? We were told that the adviser would have taken too long. However, PASC has established that Sir Philip’s successor, Sir Alex Allan, will conduct swift preliminary inquiries if asked to do so, so that he can play his proper role. The problem of public perception was all the more acute in the case of the Secretary of State for Culture, Olympics, Media and Sport and the conduct of his special adviser, Adam Smith.
	The problem with the present system is that as soon as the question of a serious potential breach of the code and a possible referral to the Prime Minister’s adviser arises, the Prime Minister is damned if he does, and damned if he does not. Referral is seen either as condemnation of the Minister’s conduct or as an attempt to protect the Minister from a full investigation. The same damage is done to the reputation of the Minister in question who, if innocent, would doubtless prefer the clean bill of health given by an independent investigation. In the more recent case, we finished up with one of the most unpleasant and acrimonious debates in the House of Commons that I have ever witnessed. The office of the independent adviser was set up to improve public confidence in the conduct of Government, but that episode does not vindicate it as a success.
	Changing the procedure would avoid all that. It would make the adviser more genuinely independent, and it would help to remove the public suspicion that ministerial
	conduct can be protected from proper investigation. Short preliminary investigations, unimpeded by political considerations, would speed up the whole process.

Alun Cairns: I pay tribute to my hon. Friend for his chairing of the Committee and for the contribution that he is making today. I strongly support what he is saying. Can he offer the House any guidance on how we can best protect against potential witch hunts by those in the media who simply want to make life difficult for a Minister and get an investigation under way?

Bernard Jenkin: I submit that that would be a question of the robustness of the adviser. The process would operate in a similar way to that of the Parliamentary Commissioner for Standards, in that if the adviser felt that there was a serious case to answer, he would pursue it. If he thought that it was based on hearsay or tittle-tattle, he would dismiss it. Obviously, the moment at which he announced an investigation would be a threshold moment, but we have experience of that with the Parliamentary Commissioner for Standards, who operates in that manner.

Kelvin Hopkins: I support what the hon. Gentleman is saying. In response to the hon. Member for Vale of Glamorgan (Alun Cairns), I think that media witch hunts would be less likely if the new arrangements were to be adopted, because the media would be less suspicious that anything untoward was happening.

Bernard Jenkin: The hon. Gentleman also serves on the Committee, and I am grateful to him for his participation. He makes his point extremely well. Witch hunts start when there is a suspicion that the Prime Minister is seeking to protect a Minister from an investigation. That is when the media—and, indeed, Her Majesty’s official Opposition—tend to jump on the bandwagon.

Andrew Miller: I want to express my full support for the motion and for the Committee’s report. There are certain questions that many people will ask, and they need to be put on public record. To whom should the independent adviser be directly accountable, and who should appoint him if we are to ensure the maximum degree of genuine independence?

Bernard Jenkin: The hon. Gentleman raises a salient point. The manner of the adviser’s appointment was mentioned in the report, although I am not going to address it directly today. In 2003, before the post was established, the Committee on Standards in Public Life originally recommended that the appointment should be made through the public appointments process and overseen by the Commissioner for Public Appointments. That has not happened. It did not happen with the appointment of Sir Alex Allan, and we have been highly critical of that fact. We believe that there should be an open public appointments process for this role, as there is for any other significant public appointment.

Julian Lewis: My hon. Friend seems to be making an unanswerable case. Will he explain to the House the present position if a Minister
	chooses to refer him or herself to the independent adviser? Would that position change if his proposals were adopted?

Bernard Jenkin: I imagine that any Minister who pressed the Prime Minister for referral should be granted one; however, it might be granted or it might not be—it is a matter for the Prime Minister. That is that. I do not know what a Minister who wanted to be referred would do if the Prime Minister refused that; I think he would just have to lump it.

Robert Halfon: It is a privilege to serve under my hon. Friend’s chairmanship on the Public Administration Select Committee. Will he confirm that, although the report recommends that the Prime Minister’s adviser should be independent in making the decision, he will nevertheless operate under a clear set of guidelines to help him make that decision?

Bernard Jenkin: I think the guidelines are the ministerial code, and it should be for the adviser to determine his own process, but it is perfectly reasonable for the Government and the Prime Minister to insist that the adviser has a quick process to establish prima facie cases and decide whether they are worthy of further investigation rather than go into the full process straight away. I can understand the Prime Minister being reluctant to refer cases to Sir Philip Mawer, who had established a very long, tortuous and indisputably fair process, but not one that could be quick under the pressure of political events as required.

William Cash: Has my hon. Friend given any thought to his own Committee’s involvement in pre-appointment scrutiny in the light of the comments and thoughts of the Liaison Committee on such questions?

Bernard Jenkin: We held a hearing with the new adviser on Minister’s interests, but we were anxious—at least, I was anxious—to make it clear that it was not a pre-appointment hearing. Personally, I have absolutely no doubt of Sir Alex Allan’s bona fides and integrity. Unfortunately, we expressed the view that the manner of his appointment undermined the idea that he is actually an independent adviser, although he is certainly an adviser. He has a day job, too, in that he advises Ministers on their respective private interests and potential conflicts of interests, and ensures that there is a register of Ministers’ interests. That is his main job, and I have no doubt that he does it extremely efficiently. As I say, however, the manner of his appointment does not lead the public to believe that he is truly independent.

Gareth Thomas: Does the hon. Gentleman have any plans to persuade his Committee to do further work in this area, perhaps in line with Sir Philip Mawer’s suggestions for trying to establish ground rules for assessing whether Ministers should be suspended as and when an investigation is taking place—a suggestion made in answer to an earlier question from the hon. Member for Vale of Glamorgan (Alun Cairns)?

Bernard Jenkin: We are certainly minded to conduct a further inquiry into the ministerial code at some stage. At the moment, we are waiting for the Government to respond to our latest report on the Prime Minister’s adviser.
	To reiterate, the Parliamentary Commissioner for Standards has the power to instigate his own investigations. Who would suggest now that he should not? His office would command little public support and therefore provide little protection for the reputation of this House and its Members. Other systems in countries such as Canada allow political ethics regulators to instigate their own inquiries into ministerial conduct. How can the Prime Minister—any Prime Minister—be objective or, perhaps more importantly, be seen to be objective when he has to make judgments about close colleagues that could have far-reaching political consequences? I appreciate that Government insiders, including my right hon. Friend the Prime Minister, see this as a potentially huge change, but those who are outside government and are not imbued by being in government see this as a very obvious change to make.
	Today, on the last day of term, not many colleagues are here, but I nevertheless intend to press this matter to a vote. I challenge Ministers not to resist, and I challenge Labour Members, too, to show how they now embrace what they resisted when they were in office. I have no doubt where public sentiment lies, so let us not delay any longer to bring about what should have been implemented years ago, for this issue will return again and again. PASC will return to it, too, until this recommendation is accepted.

Several hon. Members: rose —

Nigel Evans: Order. If hon. Members will resume their seats, let me announce that this debate is time limited to 2.20 pm. I intend to call Gareth Thomas at 1.58 pm for 10 minutes, Nick Hurd at 2.08 pm for 10 minutes, and finally Mr Jenkin to sum up in the last two minutes. Six Members wish to contribute, so I ask them to take account of the time constraints in order to be fair to others.

Lindsay Roy: Before making a few substantive points, I would like to thank the Backbench Business Committee for prioritising this debate, ensuring that we have time for it on the last sitting day before the recess. The Backbench Business Committee has earned our respect and admiration for ensuring that such vital matters are the focus of attention—and what could be more important than propriety and integrity in public life?
	I congratulate the hon. Member for Harwich and North Essex (Mr Jenkin), the Chairman of the Public Administration Select Committee, on his powerful speech, which set out a clear rationale for the independence of the adviser on the ministerial code of conduct. I commend the hon. Gentleman’s tenacity and his determination to succeed in pursuing this vital issue. It is a matter that has the support of all PASC members, and indeed the independent Chairs of other Select Committees.
	I, too, start from a premise—one that it is absolutely fundamental to effective government that must abide by underpinning principles of integrity, fairness, openness
	and transparency. I have no doubt whatever that it was in that spirit that the office of the independent adviser on Members’ interests was established. It was, I believe, set up in good faith, with the Prime Minister having the power of decision on whether or not to instigate investigations. However, based on experience over the last four years, that notion is well past its sell-by date. Since that time, we have seen a dramatic turn of events, including the expenses scandal, which has called the integrity of Parliament into question. To put it bluntly and specifically in relation to the ministerial code, experience over the last few years underscores the need for outright independence.
	When in opposition in 2010, the Prime Minister promised to strengthen the ministerial code. He said:
	“we must remember that we are not masters but servants. Though the British people have been disappointed in their politicians, they still expect the highest standards of conduct. We must not let them down.”
	When questioned in a recent interview about six significant changes in Government policy, he said:
	“When you’ve got something wrong, there are two things you can do in government: you can plough on regardless, or you can say, ‘No, we’re going to listen, we’re going to change it, we’re going to get it right.’”
	My challenge to the Prime Minister is to say, “Stop ploughing a lone furrow, and take this opportunity to ‘get it right’”. The strength of feeling in this House and in the wider public domain sends a clear message—that the application of scrutiny of the ministerial code lies not just with the Prime Minister, but indeed with the whole House. The overwhelming view is that the independent adviser must be given the power to instigate his own investigations on our behalf.
	The retirement of Sir Philip Mawer provided a timely opportunity for the Prime Minister to change the status of, and relationship with, the independent adviser. However, not only was that golden opportunity missed but, to add insult to injury, the new appointment was made through a closed recruitment process. This added fuel to allegations that the independent adviser was merely a pawn of the Prime Minister. So let me make my position very clear: no longer can the Prime Minister act as team captain, goalkeeper and referee at the same time; no longer can the Prime Minister alone dictate the interpretation of the rules that might merit invoking an independent investigation; no longer should we need to devote part of an Opposition day to debating robust and fair application of the code, and neither should we have the highly charged and intensely heated exchanges, to which our Chairman referred earlier, within this Chamber that characterised the most recent debate.
	In these volatile political times, the concentration of such power in the hands of the Prime Minister leaves him open to charges of partisan treatment and bias. Because ours is a largely unwritten constitution, we must be particularly careful that institutions and political offices retain their integrity and credibility. An independent adviser must have the authority to speak truth unto power. In addition, there are weighty matters of state that demand the Prime Minister’s full attention, both at home and abroad. With such a heavy and important political agenda, the argument that application of the “Ministerial Code” must be vested in the adviser is all the more cogent.
	I entirely endorse the summary by the Public Administration Committee, which states:
	“The reform of ethical regulation in British public life must be undertaken openly, consensually and on the basis of sound principle.”
	Whatever the reality, there is a public perception of ad-hockery surrounding the appointment of the independent adviser by the Prime Minister, and the current situation creates further attention to bring our political process into disrepute. I urge everyone to support the motion so that we can ensure that there is a real separation of powers when we are dealing with the propriety and integrity of Members of this august House.

Mark Reckless: Paragraph 1.5 of the
	“Ministerial Code” states:
	“Ministers are personally responsible for deciding how to act and conduct themselves in the light of the Code and for justifying their actions and conduct to Parliament and the public. However, Ministers only remain in office for so long as they retain the confidence of the Prime Minister. He is the ultimate judge of the standards of behaviour expected”.
	The passing of this motion would change that. Rather than decisions being made by Ministers and the Prime Minister, an independent adviser would, at his own instigation, pass judgments on Ministers. The Prime Minister is Prime Minister because he commands a majority in the House, and under our constitution it is the Prime Minister who appoints Ministers who are accountable to him and to the House, but passing the motion would change that.
	What worries me is that a huge constitutional weight would be placed on the “Ministerial Code” for which it is entirely ill-suited. This document has not been approved by the House; it has not even been approved by the Cabinet. John Major’s Cabinet agreed to publish it, but there was a strong view that it should not be published because it would lead to inappropriate weight being placed on it. At best it is a prime ministerial document, but in reality it was only under Attlee that that was the case.
	According to what I believe is the only history of the development of the “Ministerial Code”, by a lady called Amy Baker,
	“Attlee had tailored the document very much to his own style and the needs of his own Labour administration—and succeeding Prime Ministers may have followed suit, had the Cabinet Office not intervened.”
	However, the original Cabinet Secretary, Hankey,
	“had drafted the very first guidelines in order to establish some continuity of procedure which would enable the Cabinet Office to organise business without being disrupted too much on a change of government.”
	We know what has happened as the code has developed. Winston Churchill took no interest in it and Eden refused to issue a code, but it was used by Macmillan. Home and then Wilson took over in 1963 and 1964, and the Cabinet Secretary claimed that the document bore the great imprimatur of various Prime Ministers when that was in fact not the case. What had happened in 1963 and 1964 was used to push through paragraph 4.7,
	which puts junior Ministers under the thumb of the permanent secretary and says that they cannot tell the permanent secretary what to do even if the Secretary of State is happy for them to do so. According to Amy Baker’s book, at the time that
	“may have seemed quite convenient”
	to the drafters of what was then “Questions of Procedure for Ministers” ,
	“who knew that their amendments would now be ‘automatically’ approved by the new Prime Minister”.
	Similar circumstances arose when Margaret Thatcher became Prime Minister in 1979 and the rules governing the roles of parliamentary private secretaries changed. According to the book,
	“amongst those directives which senior officials selected for incorporation into QPM, were instructions prohibiting dissent in the Commons from parliamentary private secretaries.”
	Again, we see a system whereby the House is denuded of its rights and civil servants decide what happens to the “Ministerial Code”.
	According to a former Cabinet Secretary,
	“This process meant that on a change of government, senior officials in the Cabinet Office had a wider discretion to initiate amendments, as the incoming Prime Minister would be unaware of recent issues and would generally approve the draft handed to them on appointment.”
	That is how we arrived at the reference to an overarching duty to obey international law. There is no basis for it in this Parliament or in our courts, but if the motion is passed, the position will become even worse. No only will the code be a constitutional document, but a retired civil servant will decide how it applies to each individual Minister, and I think that that is wrong.

Paul Flynn: We have seen the degradation of a very valuable reform that was made when Tony Blair was Prime Minister. I was a member of the Public Administration Committee at the time, and we were not happy with everything that the last Government did. We wanted to go further: we wanted a pre-appointment hearing. However, if we look at the history of the code, we see that it was used once by the last Government on an occasion involving Shahid Malik and has not been used by the present Government in three serious cases, although it was used in a minor case.
	We should heed what was said about lobbying by the Prime Minister when he was in opposition, and in last week’s report from the Political and Constitutional Reform Committee. When in opposition, the Prime Minister said, quite rightly, that lobbying was the greatest scandal facing us, and that money was buying power and power was fishing for money. Sadly, that is exactly what has happened under this Government, and to an even greater extent. We must look to our reputation. We must recognise the fact that we are not winning back the trust and the confidence of the people, which is our prime task after the expenses scandal, but are losing that trust and that confidence and providing even greater cause for scandal.
	The first of the three cases that should have been investigated by the independent adviser, as he says himself, was the case of the right hon. Member for North Somerset (Dr Fox). We now have a new doctrine of
	absolution by resignation: those who resign will not be subject to a full investigation of their conduct by the only legal enforcer of the “Ministerial Code”. An investigation was carried out virtually over the weekend for party political reasons, in order to get it over with rapidly.
	The second case involved a Minister who argued that he did not have to declare a meal with which he had been provided by a lobbyist because on the day in question he was digesting with his private rather than his ministerial stomach. That was accepted, and no investigation was carried out.
	Thirdly, there was the case of the Culture Secretary, on which we had a debate the other day. I believe that we must look to the conduct of the adviser on that. In extraordinary circumstances, following receipt of a letter from the Prime Minister dated the day of the debate, an answer came back before 12 pm virtually absolving the Minister involved of the charge that he and his staff had been approached by a lobbyist 500 times, because it had been deemed not to be a legitimate area for investigation. All those cases should have been investigated under the “Ministerial Code”.
	I am grateful to the Chairman of the Public Administration Committee, which is behaving as it should. There is unanimity on the Committee about the reform that is necessary. When the new independent adviser appeared before the Committee, I asked him what he would do if we expressed our unhappiness about his appointment. We suggested that he had a reputation for being a poodle—for having followed Ministers around for years, obeying them with “Yes sir” and “No sir”. That had long been his role. He was not the Rottweiler that we needed. He said that if we expressed our unhappiness he would consider relinquishing his post, and we did express our unhappiness. I believe that before appointing such a person we must decide by means of a pre-appointment hearing whether he possesses the necessary robust independence.

Robert Halfon: Does the hon. Gentleman consider that the ratifying of the “Ministerial Code” by Parliament would deal with some of the objections raised earlier by my hon. Friend the Member for Rochester and Strood (Mark Reckless)?

Paul Flynn: No, it would not, because, under this Government, in the three serious cases I have mentioned, the code has not been used, when it should have been. The only time it has been called upon was in a case of some triviality, where the person involved admitted her guilt, and that went through. These other serious potential abuses have not even been investigated, and we must question the impartiality of the adviser because of his conduct on the day of the debate in question. All the misgivings we had were justified.
	We, as an institution, are in grave danger of deepening public cynicism against us. We have had new cases of allegations, backed up with films showing a lobbyist trying to get access to the Prime Minister or boasting of access—

Nigel Evans: Order. Time is up. I call Sir Alan Beith.

Alan Beith: The Public Administration Committee has been consistent on this matter, and it has been right on this matter. It is not about the choosing of Ministers; it is not even about the dismissal of Ministers. It is about ensuring that, if there is the possibility of impropriety in ministerial conduct, that can be investigated. It is too much to expect the Prime Minister not to be influenced by other factors in deciding whether to refer such a matter. To lose one Minister is bad enough; to lose several is careless. The Prime Minister will always have an anxiety that an adverse report by the investigator could lead to his needing to dismiss a Minister. It is simply naive to suppose that no Prime Minister will be affected by such considerations. Therefore, the adviser should be free to initiate investigations. Indeed, they would often do so in circumstances where it is to the advantage of the Minister concerned that there be a straightforward, clear and swift way of vindicating him, if he is innocent.

Kelvin Hopkins: I rise to speak briefly in support of the comments of the hon. Member for Harwich and North Essex (Mr Jenkin), the Chair of the Select Committee. He put the case very well. We do not need to use extreme language, as the proposal is common sense, particularly given recent events. We want an investigator who has the capacity to conduct proper investigations and offer advice. The constitutional relationship between the Prime Minister and this House would not be changed by that. He could accept or reject the advice, but at least investigations could be made independently, without having to ask the permission of the Prime Minister first. That would be a significant change.

Mark Reckless: Regardless of the formal situation, does the hon. Gentleman accept that the political reality will be that if this independent investigator decides to conduct an investigation off his own bat and then gives a withering condemnation of the Minister concerned, it would be very difficult for the Prime Minister to keep that Minister in office, and de facto control would pass to the adviser?

Kelvin Hopkins: I trust that the investigator would make a withering condemnation only if that were justified. The recent events surrounding the right hon. Member for North Somerset (Dr Fox) and his amanuensis, Adam Werritty, deserved to be thoroughly investigated, but in my view they were not properly investigated.
	Such a situation would not arise in future. I hope the Chairman of the Select Committee will not mind my mentioning that we will undertake a report on special advisers. I hope we will recommend putting their relationship with Ministers on a better footing in future, so that situations such as the Adam Werritty case do not arise again.
	This proposal is timely. Recently, Prime Ministers have operated in an extremely powerful, individualistic way, and in a secretive way. They have often not trusted full Cabinets to discuss important matters. We are now moving towards a situation where the Prime Minister
	will be a little more open and accountable, without damaging our constitution in any way—in fact, this proposal will improve it.

Bob Stewart: It seems to me that the Prime Minister will be assisted by this appointment of an independent investigator, as he will not have to make these tricky decisions.

Kelvin Hopkins: I thank the hon. Gentleman for those comments. A situation might arise in which a Minister who has not behaved very well is a personal friend of the Prime Minister of the day. The Prime Minister could then say to the Minister, “Well, the investigation wasn’t instigated by me. It was instigated independently, and I have to accept the advice of the report. It is not me who is causing you difficulty; it’s the investigation by the independent adviser.”
	In every way, therefore, this proposal is a progressive advance that is in keeping with the spirit of the times. I hope that in future more of the Prime Minister’s current powers will be devolved.

Greg Mulholland: rose—

Nigel Evans: I will not put the clock on you, Mr Mulholland, but I ask you to resume your seat at 1.58 pm.

Greg Mulholland: I am a member of the Public Administration Committee, and I am very proud that we have come up with this sensible and important proposal. It is hugely important for Parliament, as it addresses the holding of Ministers to account, which is one of our key roles. We must remember that it is important outside this place, too; it is important to ordinary people, who saw the unseemly events of the past few months and have therefore come to regard the current system of accountability as wholly inadequate. Recent episodes have also left a nasty taste in the mouths of Members on both sides of the House, who agree that the current situation is wholly unacceptable.
	When Sir Alex Allan appeared before our Committee, we had what can only be described as a wholly unsatisfactory discussion with him in respect of both the realities of the role and, I am afraid, our confidence in his ability to perform it as it should be performed, rather than as it is, sadly, currently performed.
	We must remember that this proposal was introduced by the previous Government. In response to the predecessor Committee’s previous report on the issue, they made it clear that the appointment would be a personal one by the Prime Minister and that he would need to have confidence that the person appointed would be able to provide independent and impartial advice.
	We want the Minister to say that the Government will accept our sensible proposal, and we also want the Opposition to agree to it; they must accept the original principles of this new office as set out under the last Government. I have asked the same of the Deputy Prime Minister, and I believe that he is happy to do so on behalf of the Liberal Democrats.
	The full title of this post is “the independent adviser on ministers’ interests” but the simple reality is that it is the Prime Minister’s adviser on ministers’ interests. The current title is fraudulent and misleading to Parliament and the public. If these reforms are not accepted and implemented, the Government should at least have the decency to change the title to “the Prime Minister’s adviser on ministers’ interests.”
	Sir Alex Allan was appointed to the post with no open competition. We do not believe anyone else was even in the frame for the job, and there was no detail whatever on the process he went through. That is simply unacceptable.
	Our proposal is based on an extremely simple idea. If—free from political interference and regardless of any media witch hunt—the independent adviser believes there is sufficient genuine evidence for an investigation, he should intervene. That is all we are asking for.

Nigel Evans: Order. Time is up. I call Gareth Thomas.

Gareth Thomas: This has been a brief but interesting debate. I commend the work of the Public Administration Committee, chaired by the hon. Member for Harwich and North Essex (Mr Jenkin). He has rightly received praise for the tenacious way in which he and his Committee have pursued these issues. I hope he will forgive me if I praise my hon. Friend the Member for Newport West (Paul Flynn), too, for he has also pursued these issues with considerable vigour and tenacity.
	I studied the contributions of all Select Committee members. I carefully read the questions they put to Sir Philip Mawer and Sir Alex Allan, and noted in particular the contributions of my hon. Friend the Member for Luton North (Kelvin Hopkins), who is also a consistent campaigner on these issues, my hon. Friend the Member for Glenrothes (Lindsay Roy), and the hon. Member for Leeds North West (Greg Mulholland). They all made good contributions to this debate, too.
	This debate would not have the resonance it currently has outside the House if it were not for the Prime Minister’s mishandling of key questions about possible violations of the ministerial code—a point that was implicit in the speech of my hon. Friend the Member for Glenrothes.
	The Opposition remain determined to take the steps necessary to continue the process of restoring trust in the political process. When we were in government, we took steps to reform Parliament, passing new laws to protect our democracy. We acted to increase transparency and strengthen public accountability for Members of the House of Commons. On ministerial accountability, we also introduced further reforms. The then Prime Minister, my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown), introduced the publication of an annual report and a list of Ministers’ interests, again to increase transparency and Ministers’ accountability to this House. He also appointed Sir Philip Mawer as the independent adviser on ministerial interests, calling on him, as a number of Members have mentioned, to investigate the then Member for Dewsbury in May 2009, against whom a particular allegation—it was unfounded,
	as it turned out—had been made. Sir Philip investigated and the Minister was cleared and returned to his ministerial duties.
	I have a number of questions for the Minister and, if I may, the Chairman of the Public Administration Committee, but the context of our debate is worth touching on. It is the Prime Minister’s refusal, using the Leveson inquiry as his reason, to ask Sir Philip’s successor, Sir Alex Allan, to investigate the conduct of the Secretary of State for Culture, Media and Sport, and the Prime Minister’s failure to call in the independent adviser in the case of the right hon. Member for North Somerset (Dr Fox), that form the backdrop to our debate. The fact that so many Members wanted this debate is in no small part due to the Prime Minister’s refusal to use consistently a system which the last Prime Minister established and used, but which the current Prime Minister now appears unwilling to use—except when he is sure of the outcome.
	In short, the motion before the House today is the direct result of the belief of too many Members, on both sides of the House, that the Prime Minister has mishandled his responsibility for the ministerial code.

Bernard Jenkin: I resent the hon. Gentleman making that implication, because I do not think that it does reflect why all the signatures are on the motion. What it does reflect, however, is the fact that the previous Labour Government did not accept this recommendation from the predecessor Committee. It is incumbent on him to explain whether the Labour party has now changed its mind and will support this motion, or whether he is just going to use this opportunity to make political points in this debate.

Gareth Thomas: I will come to the position that Opposition Front Benchers are taking, but the Chairman of the Public Administration Committee is wrong not to recognise the considerable concern on the Opposition Benches—and the Government Benches—at the Prime Minister’s decision not to refer the case of the right hon. Member for North Somerset to the independent adviser, which I understand prompted the Committee’s original inquiry into this issue in this Parliament. The Prime Minister’s more recent decision to refer the case of the noble Baroness Warsi and not that of the Culture Secretary has galvanised interest in the Committee’s work in this area.
	The shadow Leader of the House, my hon. Friend the Member for Wallasey (Ms Eagle), set out in her speech on 13 June some detailed concerns, which I do not intend to dwell on now, about the Prime Minister’s failure to uphold the code and to ensure that an appropriate investigation took place.

Alun Cairns: The hon. Gentleman talks about the Opposition’s concern about this issue, but does he not accept that their remarks would have far greater traction if they said that they now supported the motion and regretted not having taken action when in government?

Gareth Thomas: As I think I set out earlier, we did take action when we were in government, and the House is better for it. However, I want to come to some of the points that the hon. Gentleman made not only in this debate but in the Public Administration Committee’s hearings.
	There is a particular outstanding question that the Prime Minister still needs to answer, and perhaps the Minister can give us some clarity on it. Why is it appropriate for the independent adviser to be used in the case of the noble Baroness Warsi and not that of the Culture Secretary? I also have a series of questions on which I would welcome the views of the Chair of the Public Administration Committee in his concluding remarks. As I hope I made clear, I think some further work by his Committee in this area would be useful for the whole House, not least in questioning the current ministerial adviser on his lack of consultation in the case of the Culture Secretary.
	The new independent adviser told the Committee when giving evidence that he had made the point to the new Cabinet Secretary, Sir Jeremy Heywood, that
	“there are advantages to him in bringing the Adviser in early and whenever major issues arise.”
	That appears at odds with the comment in a letter from Sir Alex that was deposited in the Library, accepting the Prime Minister’s decision not to refer the case and noting the work of the Leveson inquiry, and with the clear view of Sir Brian Leveson that his inquiry was not an appropriate place for the Secretary of State’s conduct to be investigated. I raise this question not in any way to express doubt about Sir Alex’s capacity or commitment, but to inquire whether the Committee will continue to explore the circumstances in which it would be appropriate for the ministerial adviser to be brought in, and to suggest—in a spirit of helpfulness, I hope—that Sir Alex’s evidence may well be helpful in that context.
	Will the Chairman of the Public Administration Committee be summoning the Cabinet Secretary to explore the extent to which there was consultation with Sir Alex over the Culture Secretary’s case? In my intervention on the Chairman, I raised the possibility of further work by his Committee in this area, highlighting two issues that Sir Philip Mawer raised, in part in answer to some questions from the hon. Member for Vale of Glamorgan (Alun Cairns): whether suspension of a Minister is really possible during a code investigation in practical political terms; and the possibility of the Committee helping to establish a set of “ground rules”—his words—for a situation where an investigation is under way and the media is in full pursuit of that Minister.
	The Opposition will listen carefully to the position and argument that the Minister, and indeed the Public Administration Committee Chairman, develop. We will want to consider the Government’s response to the Committee’s report, which it is a pity was not available for today’s debate. I have genuinely an open mind on this issue. The Opposition’s instinct is that further work is required.
	This debate is born out of frustration with the Prime Minister’s handling of his responsibility for the ministerial code.

Greg Mulholland: Will the hon. Gentleman give way?

Gareth Thomas: I am winding up.
	The failure to use the independent adviser in the case of the right hon. Member for North Somerset, compounded by the failure to contemplate using him in the case of the Culture Secretary, provides the context for this
	debate. Sadly, it is yet another debate called in this great House because of the errors of judgment of the current Prime Minister.

Nick Hurd: I am grateful to the hon. Member for Harrow West (Mr Thomas) for clarifying the Labour party’s position on this issue—or not. I would like to begin by registering my personal respect for my hon. Friend the Member for Harwich and North Essex (Mr Jenkin) and the other members of his Committee for their persistence on this matter. I note carefully his comment that that persistence is not going away. I also note, on the Government’s behalf, that the motion has cross-party support and has been signed by a number of distinguished Chairmen of Select Committees. This short debate is therefore one the Government must listen to, and I believe are listening to, carefully, and we will consider carefully what has come out of it.
	I think it would be helpful if I restated an important principle that the Labour party also clung to in its 13 years in power: when it comes to the ministerial code, the Prime Minister is the ultimate judge of the standards of behaviour expected of a Minister and the appropriate consequences of a breach of those standards, as my hon. Friend the Member for Rochester and Strood (Mark Reckless) pointed out. The bottom line is that Ministers remain in office only for as long as they retain the confidence of the Prime Minister. He or she decides, and is accountable to Parliament for those decisions.
	The advent of an independent adviser is clearly welcome, although the Labour party seemed to fight it for many years, and he or she clearly has an important role. It is worth clarifying that there are two aspects to the role, both of which are important. One part of the role is, at the request of the Prime Minister, to look into allegations of breaches of the ministerial code, if the Prime Minister thinks that is necessary, and to advise the Prime Minister. But it is for the Prime Minister to take this decision and be accountable for it. In some cases, the Prime Minister will have no need to ask for advice, as the issues will be clear. In other cases, there may be the need for further investigation before the Prime Minister can take a decision. In those instances, he will refer to the independent adviser.
	It is to misunderstand the intended role of the independent adviser to suggest that he or she should be able to instigate his or her own investigations. The adviser is there, personally appointed by the Prime Minister, to advise the Prime Minister on allegations of breaches of the code, if the Prime Minister thinks it is necessary. I shall now read out an important quote from the Prime Minister’s evidence to the Liaison Committee on 3 July:
	“The ministerial adviser on interests is there to advise the Prime Minister; he gives the advice and the Prime Minister has to make the decision.”
	There has been no change in approach; this is the same practice that existed under the previous Government.

Greg Mulholland: I am listening with interest to my hon. Friend, as he is actually dealing with the issue, unlike the hon. Member for Harrow West (Mr Thomas) in his extraordinary and pathetic contribution. Does
	my hon. Friend not accept that if the independent adviser had the powers we are talking about, he himself would say that there is not the evidence to proceed with an inquiry? The proposed approach would do that job and give the public that there was no need for an inquiry in the first place.

Nick Hurd: I thank my hon. Friend for his intervention, and I can see the passion with which he makes his argument, but the important principle is who is ultimately responsible, and that is the Prime Minister.

Paul Flynn: The Chairman of the Committee on Standards in Public Life, Sir Christopher Kelly, said in evidence to the Public Administration Committee that in his view the Prime Minister had broken the ministerial code in one of these instances. As the Prime Minister is unlikely to refer himself to the adviser, is it not crucial that we have someone of independence who can take on the Prime Minister when he is suspected of breaking the ministerial code?

Nick Hurd: I have not seen Sir Christopher Kelly’s evidence on that, but there is no shortage of opportunities to hold the Prime Minister to account on anything.
	Providing advice to the Prime Minister on allegations about a breach of the ministerial code is one aspect of the independent adviser’s role. I also wish to explain the other important aspect of the role, as it has been ignored in the debate: the adviser provides an independent check and source of advice to Ministers on the handling of their private interests in order to avoid any conflict between those interests and their ministerial responsibilities, as set out in section 7 of the ministerial code. This is very much behind-the-scenes work; it is about sorting out issues before they arise. However, it does result in the publication by the Cabinet Office of the list of Ministers’ interests, which puts into the public domain a list of all the relevant interests of all Ministers and enables external scrutiny of possible conflicts of interest. Obviously, this is an ongoing process as issues arise, not a one-off. It is important to put on record that second dimension to the independent adviser’s work.
	Some questions were raised about particular cases this afternoon, although I think that the hon. Member for Harrow West struck the wrong tone, not for the first time, by seizing the opportunity to try to make a political attack on the Prime Minister. Rather than rehearse some arguments about why one particular case was referred or otherwise, I simply say that in each case—those of the former Secretary of State for Defence, my right hon. Friend the Member for North Somerset (Dr Fox), my right hon. Friend the Culture Secretary and Baroness Warsi—there were no shortages of opportunities for the House or for the media to hold the Prime Minister to account for the decisions he took.

Mark Reckless: Did not the hon. Member for Newport West (Paul Flynn) go beyond that by suggesting that the code, rather than being a prime ministerial document for Ministers, actually applies to the Prime Minister, too, and that the independent investigator should investigate whether the Prime Minister has breached it? If that were the case, should we not all just pack up, go home and let the independent advisers decide everything?

Nick Hurd: I share my hon. Friend’s reservations about placing too much weight and responsibility on someone who is ultimately an adviser, and this will not be the first time that the hon. Member for Newport West has overstated his case. The point that I was trying to make about the political attacks on the Prime Minister by the hon. Member for Harrow West was that the reasons in each particular case that he cited were made public and the Prime Minister, as we are extremely well aware, was held very accountable for all those decisions.

Mark Durkan: Does the Minister not recognise that history shows that the ministerial code has been invoked more as a shield against public and parliamentary accountability than as a tool for enabling those things? For as long as the code remains the personal app of the Prime Minister and the independent adviser does not have independence, surely all we are looking at is a feeble cross between a figment and a fig leaf.

Nick Hurd: The hon. Gentleman gives me an opportunity to discuss the issue of whether Sir Alex is independent enough, which featured in the thrust of the argument from many hon. Members.

Robert Halfon: Following on from the point made by the hon. Member for Foyle (Mark Durkan), does my hon. Friend agree that to solve this problem the ministerial code should be ratified by Parliament?

Nick Hurd: I thank my hon. Friend for his intervention and for his suit, which has enlivened proceedings today.
	In the time available to me, I wish to make a comment about the issue of the independence of Sir Alex Allan, because it has been suggested that he is not independent enough or even that he is perhaps not up to the job, having only just retired from a senior role at the heart of government before taking up the role. As I have said, this is a personal appointment by the Prime Minister of the day. A number of qualities are required for the job. In particular, the independent adviser needs to be somebody whose expertise and experience enable them to provide confidential and trusted advice to Ministers and their permanent secretaries. It is our judgment, and the judgment of the Prime Minister, that Sir Alex Allan has that experience, as well as the necessary skills and judgment to make him ideally suited for the role.
	In conclusion, today’s debate has shown the range of views on the issue. I hope that we have made it clear that the Government treat issues of ministerial conduct with the utmost seriousness. The Government will reflect carefully on the points made in this debate, and will reflect on them in our response, overdue as it is, to the Public Administration Committee report. That response will be published shortly.

Bernard Jenkin: I am extremely grateful for the opportunity to reply to this debate, Mr Deputy Speaker. It is custom and practice in this place to say what an interesting debate we have had, but we really have had an interesting exchange on this occasion. I am very grateful for, and indeed touched by, the warm remarks of members of the Public Administration Committee who have made comments about how much they enjoy working on that Committee—that goes for me, too. I very much appreciate their participation and support for our activity.
	Many of those hon. Members spoke in this debate, but by far the most interesting contribution was made by my hon. Friend the Member for Rochester and Strood (Mark Reckless), who raised a number of interesting things about the ministerial code. We are not debating its content; we are debating how the code should be enforced. He should somehow take part in our inquiry into the ministerial code, when we get to it, because he has a lot of important and interesting contributions to make, but I submit to him that the code should be owned by Parliament and controlled by Parliament in order that it can become a mechanism that can be used by Parliament to hold Ministers to account.
	Let us remember that the code was secret until quite recently. It was published only recently and it was only very recently that it started being referred to in statute. The point has been made that a change has been smuggled in whereby Ministers have to obey international law even if there is no statute that requires them to obey that law. That is an extraordinary constitutional innovation and it is one of the things that we would want to look at.
	I want to complete my remarks by referring to the two Front Benchers. They are both erudite and intelligent people who have done their best to avoid addressing the crunch issue. I understand why the Government are reluctant to make the change, but I am prepared to press this to a vote because otherwise we will be back again having exactly the same debate as we always do. I put it to the Opposition spokesman: if we finish up with another debate moved by the Opposition on why somebody has not been referred—
	One hour having elapsed since the commencement of proceedings on the motion, the Deputy Speaker put the Question (Order, 11  July ).
	Question agreed  to .
	Resolved,
	That this House calls on the Government to implement the recommendation made by the Public Administration Select Committee in paragraph 44 of its Twenty-second Report of Session 2010-12, The Prime Minister’s Adviser on Ministers’ Interests: independent or not?, that the Independent Adviser on Ministers’ Interests ‘should be empowered to instigate his own investigations’; and notes that this motion has been agreed by the Public Administration Select Committee.

Summer Adjournment

Motion made, and Question  proposed ,
	That this House has considered matters to be raised before the forthcoming adjournment.—(Bob Blackman.)

HEALTH

Greg Mulholland: I rise to take the opportunity to discuss the Safe and Sustainable review into children’s heart surgery in England and Wales and the concerns about the process that led to the closure of the excellent Leeds unit. The decision was taken on 4 July. Families from up and down the country were asked to be present to give their views and the joint committee of primary care trusts—the JCPCT—deliberated in public all day. The decision was due, but it was delayed, delayed and delayed again, until it was finally announced that Leeds would close. What left a particularly nasty taste in the mouth was that it was abundantly clear when documentation was produced that the decision had already been taken and that that day, including asking the families of children who had needed to use the surgery unit, was a charade. I am afraid that that was all too typical of the way in which this process has been handled.
	There are serious questions about how the JCPCT reached that decision. It ignored clear evidence and, I am afraid to say, there has been a clear and obvious bias all along towards Newcastle. Leslie Hamilton was on the committee despite being based at Newcastle, but there was no one from Leeds. No one in Leeds or, I am sure, up and down the country was at all surprised at the decision, because we expected it. We could see that the JCPCT was simply not considering the evidence.
	In the brief time I have available I shall raise a few points and I know that my hon. Friend the Member for Pudsey (Stuart Andrew) will raise a few more. I am sure that other hon. Members will also seek to do so and I shall look forward to having a full debate in the autumn, when we can place on the record the myriad serious concerns on this point.
	First, 600,000 people signed a petition in support of the retention of the unit at Leeds, yet that was counted as only one response by the committee. At the same time, 22,000 text messages from unknown sources supporting Birmingham were counted as 22,000 submissions. So, how can the JCPCT said that it does not “count heads” when it is ignoring 600,000 people, counting them as one submission, yet counting 22,000 text messages as 22,000 separate responses?
	Why has the JCPCT watered down expert advice on the gold standard of collocation? It has adopted a watered-down version on the advice of fewer than 10 clinicians in the steering group and on the recommendation of Sir Ian Kennedy, who is not a clinician. How can the panel justify following that advice rather than that of the country’s most respected gatherings of experts in this field? How can it be right, if this closure happens in Leeds, for the Yorkshire and Humber region to go from enjoying the highest standards of collocation in the country to having the lowest?
	The Safe and Sustainable model of children’s heart surgery is also dependent on networks of care, but whereas the Leeds network was recognised as “excellent”,
	Newcastle’s was regarded as “poor”. Why is the Yorkshire and Humber moving from a centre that delivers an excellent network to one with a record of delivering a poor one?
	The JCPCT accepted the advice that 90% of doctors in the relevant areas of option B would be happy to refer to Newcastle, yet the referring doctors in Yorkshire and Humber have never been asked about that. That is simply outrageous.
	I am aware that there has been a referral from the joint overview and scrutiny committee in Yorkshire, which we fully support and insist is properly investigated. We must also consider the very worrying situation in Glasgow. The Yorkhill unit is currently failing and a separate report by Sir Ian Kennedy stated:
	“The panel had significant concerns about important aspects of the service in the surgical unit and in the broader congenital heart network. Of most concern was a lack of leadership and coherent team working. Also of concern was a sense that the provision of paediatric intensive care may be unsafe if critical staffing problems are not addressed.”
	That has not been part of the review, however, and extraordinarily the Scottish Government have now decided that three surgeons performing 300 operations is safe in Scotland. However, that is not considered to be safe in Yorkshire. That is simply unacceptable. Today we are saying that we have no confidence in the review and that we want the whole process to be reconsidered.

Siobhain McDonagh: In south-west London, the NHS has just proposed to close the A and E, maternity unit and various other services at my local hospital, St Helier. It will take 200,000 people longer to get to hospital in an emergency. On its website, outlining why it is doing this, NHS South West London states that providers
	“will have to deliver £370 million savings each year…a reduction of around 24% in their costs.”
	Yet thanks to birth rates, an ageing population and poor health due to poverty, A and E visits will go up 20% in five years and births will increase by 10%. The area’s four hospitals are overcrowded now, so try cramming the same number of patients into just three.
	What is worse is that there is no extra funding for the hospitals that remain. In no way do I support the hospital closures in north London, but at least that area gets an extra £138 million for “out of hospital” care to cope with the closures. Down in south-west London, we will get nothing. If St Helier loses its A and E, visits to the remaining three hospitals will rise by a third. Many will have to be admitted, but, with no extra funding, where can they go? Will they go on to the corridors, as in the 1990s?
	It is claimed that 50% of A and E patients will go to GPs or community services instead, but even the report by the watchdog, the national clinical advisory team, does not believe that they could cope. That is a key paper and no cuts should take place without the public knowing what the watchdog thinks, so it should be published immediately. NCAT is right to be sceptical about whether GPs can halve the numbers going to A and E. Clinical commissioning obviously makes that very attractive for GPs, but for most people in my constituency it is easier to go to a walk-in centre or
	A and E than to a GP, so A and E visits have continued to rise year after year. The fact that GPs, who are making all the financial decisions, will get more funding if there are fewer A and E visits, does not mean that people will stop going. Apparently, some GPs now realise that those plans are looking very dodgy. A poll of Sutton’s GPs has shown a majority against the closure and a similar poll is taking place of Merton’s GPs that will, I am sure, show the same.
	It is not just St Helier’s A and E that is under threat—so is its maternity unit. However, of the four hospitals, St Helier has the only maternity unit that meets clinical standards. If we lose St Helier, the other three hospitals will need to deliver a third more babies than they do now. It is widely accepted that maternity units delivering more than 6,000 births a year are a bad thing. It is far better, and far safer, to have slightly smaller units with good midwife cover, but not in south-west London, it seems.
	We will lose our children’s unit and other services, such as intensive care. The “Better Services Better Value” review states that, to compensate, GPs will force patients from all around south-west London to go to St Helier for minor, planned treatments, but who would want an operation, even a routine one, in a hospital as depleted as St Helier? What is more, making people in St Helier drive across the suburbs for A and E and maternity and making people drive to St Helier for routine operations will add literally millions of miles of journeys to our already congested roads. No, the impact of that is not considered.
	The other obvious questions have not been asked. Why would a patient from Kingston want to drive the best part of an hour to St Helier for a treatment they can currently get in Kingston? The other three hospitals do not like the idea either, as they cannot afford to lose the income from those planned treatments.
	These plans are all over the place; they are a total shambles. Next Thursday, NHS South West London was due to rubber-stamp St Helier’s closures. It booked a big theatre in Croydon in readiness, but now it has put the decision off. Good, but this is obviously not the end. St Helier has been under threat before, but now it is under threat again from a combination of cuts and GP commissioning. The demands on our four hospitals are growing, not shrinking. I hope the Minister will reassure me, and my constituents, that that disaster will not happen on his watch.

Jason McCartney: I, too, rise to speak about the Safe and Sustainable review of children’s heart surgery. The joint committee of primary care trusts—the decision-making body comprising local commissioners—was tasked with considering the pattern of children’s heart surgery services. On 4 July, it announced its decisions, which included the news that Leeds general infirmary will not provide children’s heart surgery in future.
	The two-hour radius around the Leeds heart surgery unit reaches 14.5 million people. Including check-up appointments, the unit sees 10,000 children annually and performs about 350 operations.
	I acknowledge that the decision was independent of the Government. Local council overview and scrutiny committees are free to refer decisions to the Secretary of
	State, via the independent panel. I heard this morning that our OSC has just done so; I welcome that move. Our Yorkshire body was due to meet on 24 July. Now that the committee has referred the decision to the Health Secretary, I hope he will revisit it based on the four tests stipulated for the redesign of services.

Simon Burns: If my hon. Friend is correct—and I am sure he is—in saying that his local authority OSC has referred the matter to my right hon. Friend the Secretary of State, the process is that the OSC explains why it does not agree with the decision and asks my right hon. Friend to refer it to the independent reconfiguration panel for consideration. The panel will then respond to my right hon. Friend and state whether it thinks the decision is right or wrong.

Jason McCartney: I thank the Minister. I said earlier that the decision would go to the Secretary of State via the independent panel. I look forward to its going through that process.
	The first test for redesigning services is that there should be clear clinical benefit. The health impact assessment was that option G—to keep Leeds open—had fewer negative impacts than the chosen option. The second test is clinician support. There is no evidence that the decision has the support of clinicians; in fact, most have given their support to the Leeds unit.
	The third test involves the views of the public. Surely nothing can be clearer than the views of the 600,000 people who signed the petition to keep the Leeds unit open, and the admirable cross-party support for the campaign. The fourth and final test is that there should be support for patient choice. A survey in west and south Yorkshire clearly shows that patients would not travel up to Newcastle.
	Many constituents with experience of the Leeds unit have been in touch since the announcement on 4 July.

Greg Mulholland: The evidence clearly shows that Newcastle will not hit the magic number of 400, making the point of the process farcical. As we now know that Glasgow will continue, but will perform only 300 operations a year, there will be two underperforming units, and we will have lost Leeds, which could easily reach those numbers. Does that not make the whole thing a farce?

Jason McCartney: My hon. Friend makes a good point. There is an assumption that all the patients who have been going to the Leeds unit will automatically migrate to Newcastle. That is a big flaw in the assessment, and I look forward to further exploration of that matter.
	Constituents who have been in touch with me include teenager Seb, who recently did work experience with me. He had three heart operations and a pacemaker fitted at Leeds. He wants the Yorkshire unit to stay open; he stresses the fact that there are good transport links to the Leeds unit.
	Paul told me about his 10-year-old stepson who suffered a cardiac arrest last August. His stepson had a defibrillator fitted internally, which he will have for the rest of his life. Paul said the Leeds location was key for their family.
	Ruth told me about her six-month-old daughter Eleanor who was born with a heart defect caused by Down’s syndrome. Ruth fears for the emotional and financial stress families will be put under by the longer travelling distances, as parents try to hold down their jobs, care for other children and fulfil other responsibilities.
	I was also contacted by the grandparents and, separately, the parents and siblings of four-year-old Lily Rose, who had surgery in the Yorkshire unit. They asked how a four-year-old was expected to cope at such a traumatic time without being able to see her mummy each day. The emotional impact on the rest of the family would be enormous. They stressed that distance from the centre is extremely important. They reiterated the population figures: 14.5 million people are within two hours of Leeds, whereas only 3 million are within two hours of Newcastle.
	Those cases are real; the families were in touch with me over the past two weeks. In the past year, I have spoken in the Chamber about George Sutcliffe, Ben Pogson and Joel Bearder who, with their families, have been campaigning locally for the Leeds unit to stay open. I compliment them and all the families who have worked so hard on the campaign, and will continue to do so.
	It is clear that the plans do not meet the four tests, which are factual; they are not about emotion. I look forward to the flawed decision eventually being referred by the independent panel to the Secretary of State so that the tests can be looked at again. I firmly believe the JCPCT decision clearly fails all the four tests for redesigning services, and I look forward to its being reconsidered.

Andy Slaughter: On 4 July, a committee of primary care trust chief executives made the extraordinary decision to end children’s heart surgery and intensive care at one of the best performing and largest centres in England: Royal Brompton hospital, a specialist heart and lung hospital that treats children and adults from all over the country who have some of the most severe forms of heart and lung disease. It was quite a surprise for the doctors and other staff at Royal Brompton to find out last year that they were earmarked for closure. The national review panel that made the recommendation, in February 2011, had previously specified that for children’s heart surgery centres to be viable they must have four surgeons each doing at least 100 operations every year, and they must offer round-the-clock care.
	Royal Brompton has four surgeons, each undertaking more than 100 operations every year and it offers round-the-clock care. It also has a safety and outcome record of which any centre would be proud. Rates of patient satisfaction at the hospital are exceptionally high.
	The national review of paediatric heart surgery set out to reduce the number of hospitals offering children’s heart surgery, because it was felt that in some areas surgeons did not have enough cases to maintain their skills in the longer term. London has three centres, although two of them, Royal Brompton and Great Ormond street, are recognised national specialist centres and treat patients from all over the country. The decision was made to close a London centre, and divert its patients to the
	remaining two, once their facilities are improved and extended, at significant cost to the taxpayer. A proposed solution to develop a network in London that would mean closer collaboration between the three existing centres, but no closures, was ignored.
	Time prevents me from going into detail about why Royal Brompton drew the short straw of closure; it came down to a complicated scoring mechanism that eventually ended up in the High Court. I must stress, because it is of utmost importance, that there was never any suggestion that Royal Brompton’s clinical services for children are anything other than first rate. A better insight may be provided by the comments of a civil servant at a meeting of the London specialised commissioning group on 26 April:
	“It is likely that the rest of the country will take the view that London should take its share of the pain of closures and will seek to make one closure in the capital in order to make closures elsewhere more palatable.”
	Removing children’s surgery and intensive care from Royal Brompton will have devastating consequences, and not just for the young patients who value the hospital’s cardiac care so highly. Losing its children’s intensive care unit will destroy Royal Brompton’s world-class paediatric respiratory service, which specialises in the treatment of children with cystic fibrosis, severe asthma and a number of severe and complex respiratory conditions. Without the back-up of intensive care and on-site anaesthesia, doctors will not be able to undertake the more complex specialist treatments they do now, because they will consider it unsafe to do so.
	Royal Brompton’s respiratory teams also undertake groundbreaking research into important areas such as cystic fibrosis, severe asthma, lung disease, inflammation of the airways and neuromuscular conditions. That research can be carried out only at a specialist hospital, where the combination of clinical expertise and the type and number of patients seen provides the necessary conditions. Without an intensive care unit and provision for anaesthesia, research will simply not be possible.

Greg Mulholland: The hon. Gentleman makes a passionate case for the Royal Brompton unit. The chief executive of Little Hearts Matter says that, in the Glasgow case, a unit that does 300 operations can be made perfectly safe by other means, without closing units. Does the hon. Gentleman share my frustration at the fact that in the Royal Brompton, Leeds and other places, those involved are not prepared to do that? It does not make sense.

Andy Slaughter: I am grateful for that intervention, because, in case my comments are seen as special pleading from the hospital, I was just coming on to mention some independent recommendations and sources that support the argument that, if there is no opportunity for research, and if experts—in Leeds, as well as the Royal Brompton—are prevented from working to the level of their abilities, many are likely to seek work elsewhere, possibly outside the UK.
	Dr Neil Gibson, a consultant in paediatric respiratory medicine at Glasgow’s Royal hospital for sick children, wrote to the chair of the review as follows:
	“The unit at the Royal Brompton Hospital from a paediatric respiratory point of view is truly one of the world’s leading centres with an already impressive track record…There is a
	significant potential for irreparable damage to be made to the only world class Paediatric Respiratory Research Unit in the United Kingdom.”
	Professor J. Stuart Elborn, president of the European Cystic Fibrosis Society, wrote that
	“high quality research is a key determinant of the ability of a centre such as the Royal Brompton to retain and recruit the world leading clinical and academic staff on whom its respiratory services depend. Adverse impact upon the ability of the clinical staff to carry out cutting-edge research will undermine the sustainability of the clinical services, to the detriment of its patients.”
	Asthma UK, the Cystic Fibrosis Trust, the Muscular Dystrophy Campaign, and the Primary Ciliary Dyskinesia Family Support Group wrote a joint letter to the chair of the committee, saying:
	“We have explicitly mentioned respiratory research because it is an issue of fundamental importance to each of our charities because of the excellence of the Royal Brompton’s paediatric respiratory research and clinical trials programmes and the importance of that work for improving patient outcomes in the future.”
	Patients and staff at Royal Brompton are understandably deeply distressed at the prospect of losing their high-performing children’s heart unit, soon to be followed by their specialist respiratory services. They do not understand how such a decision can be made by bureaucrats who have never visited the hospital and have no specialist knowledge of the care provided there. They have written to their MPs and to the Secretary of State. Indeed, one resourceful mother brought the matter to the attention of the Prime Minister in Downing street last Thursday.
	The Secretary of State for Health assures the parents of these seriously poorly children, and the dedicated teams that treat them, that this is a matter not for him, but for the NHS. For the sake of the thousands of children whose care will be damaged by the decision of Sir Neil McKay’s committee, the sake of the research programmes that will be destroyed, and the sake of common sense, I hope that the Minister of State will realise that the time has come for him to meet clinicians from the Royal Brompton and at least hear what they have to say. Perhaps he will be able to persuade them that destroying NHS services and research programmes that are viewed by international peers as among the best in the world is a good idea. I wish him luck in doing so.

Tracey Crouch: I am very fortunate never to have been in a situation where I have continuously required alcohol to blot out misery or pain. I am fortunate enough to have never been so drunk in a public place that my safety or personal dignity was compromised. In fact, I abhor drunkenness, public or otherwise. It upsets and frightens me that some people become so inebriated that they are incapable of standing, speaking or securing their safety.
	Although I do go to the pub, like hundreds of thousands of professional women up and down the country, I do most of my drinking at home. I probably do not think I am doing anything wrong because, every day, women go home after work and pour themselves a large glass of wine—and then another. How can it be wrong? I do not get drunk, throw up in the street, or wake up with a hangover. Yet could that be why alcohol consumption among women is becoming a problem, albeit one that may not present itself for decades?
	Alcohol consumption by women has been rising steadily since the 1960s. Since 2002 alone, the number of alcohol-related admissions accounted for by women has more than doubled, from just below 200,000 to more than 400,000 in 2010. Although I accept that there is some debate about those sets of figures, the trend is undeniably upward, not downward. Alcohol consumption by women remains at a historic high, but it is interesting to note that it is falling at a faster rate among 16 to 24-year-olds. However, a significant number of middle-aged and older women, usually on higher incomes, prefer to drink at home to dangerous levels. It is the silent majority of drinkers we should be looking to prevent from becoming risky, harmed or dependent drinkers.

Justin Tomlinson: This is a very serious issue. Does my hon. Friend agree that the silent majority are very much the problem, because they simply do not seek help?

Tracey Crouch: I agree entirely. We should remember that a significant number of people in this country do not drink at all; it is those who drink to excessive levels whom we need to be concerned about.
	Since the 1960s, many more women have entered the work force. Some have put off raising families and the associated responsibilities in favour of pursuing their career. As a result, they have much more money and time to spend drinking. That is statistically demonstrated by the fact that women in managerial or professional roles admit to drinking almost double the amount drunk by women on lower incomes.
	Where the drinking takes place, and not just the quantity, is a cause for concern. While men still account for the majority of regular pub goers, women are more likely to drink at home, drinking cheaper supermarket wine that is aggressively marketed and probably bought in bulk.

Angus MacNeil: Does the hon. Lady agree that providing calorific information, as opposed to just the unit content of alcohol, on a bottle might have a significant impact on a large number of women who care a lot about the calories that they consume? If that was set out on alcohol packaging, it might help to alleviate the problems that she mentions.

Tracey Crouch: The hon. Gentleman makes a good point. Labelling of alcohol has improved significantly over the past few years, particularly in relation to pregnant women.
	In many ways, drinking at home poses a real issue. It is difficult to assess the true extent of the problem of home drinking because the only data we have to go on are results from surveys, and many respondents are likely to under-report their consumption. However, recent studies have shown a clear link between harm and home drinking. An overwhelming 93% of recent interviewees who had all suffered alcohol-related harms bought the majority of their alcohol from off-licences and supermarkets. With alcohol now part of most people’s weekly shop, and women less likely to buy alcohol in pubs, it is no surprise that the impact of home drinking on a person’s health is likely to be more pronounced among women. Little stigma attaches to home drinking, and it is perhaps only later in life that women realise
	that there was any drawback to what they have been doing. Liver damage is an obvious related condition, but breast cancer and dementia are also often cited as conditions with a link to alcohol.
	Given that what somebody does in their own home is a matter for them, what role is there for the Government in tackling the issue? The introduction of a minimum unit price for alcohol is a welcome development and will tackle many alcohol-related problems, but I doubt very much that it will tackle the high level of drinking among well-off and professional women. It may dissuade somebody who is doing the weekly shop from taking advantage of deep discounting, and prevent the pre-loading that goes on among some younger drinkers, but more needs to be done on education and awareness.
	For professional women drinking at home who do not come into contact with the traditional services that offer alcohol-based education and interventions, the workplace could prove particularly important. Alcohol Concern is championing the need for businesses to take a responsible approach to alcohol, calling for the inclusion of an alcohol policy in the corporate governance code. In principle, workplace interventions should definitely be encouraged, and I hope that the Government will support that campaign.
	Undoubtedly, home drinking is extremely difficult to quantify. The only indication we have of the scale of the harm done is the level of alcohol-related admissions. It is therefore a concern that the official measurements used to calculate alcohol-related hospital admissions could be altered in the near future to reflect only those admissions where alcohol is a primary diagnosis. That could potentially exclude the reporting of conditions for which excessive alcohol consumption were partly responsible, such as a broken leg as a result of falling at home, or even domestic violence. I urge the Government to reconsider carefully the changes to the measurements. If they do not, we may never truly understand the scale of the problem, and the idea that we could achieve the targets set out by the Prime Minister for reducing alcohol dependency could be simply farcical.
	A vast number of women, especially in professional roles, are steadily drinking at home to the detriment of their health. That is an issue on which it is difficult to provide direct intervention, but not one that we should simply ignore. I hope that this Government, who are responsibly trying to tackle alcohol misuse, will recognise the problem and do whatever they can to ensure that it is not simply left to fester behind the closed doors of homes up and down the country.

Jonathan Ashworth: Like many other Members, I should like to say a few words about the outcome of the Safe and Sustainable review. Children’s heart surgery services in Glenfield, in the constituency of my hon. Friend the Member for Leicester West (Liz Kendall), have been earmarked for closure—a decision that came as shattering news when we heard it the other week to many of the staff who work there and many families of patients who have been treated there.
	Many of my constituents have got in touch with me, and I have also been contacted by people across Leicester and the country. I do not have time to go through
	everything that they said, but Stacey Whiteley from Lincoln has contacted me. People have contacted me from Corby, Coalville and Northampton to express deep concern and opposition to the decision. Many of them said that there were a number of questions that they wanted answered and, as I think that they are legitimate concerns, I want to put them on the record.
	My constituents have asked me, for example, why the extra options I to L were not presented for public consultation. Other constituents have pointed out that option A was the most popular, but was apparently ignored. Some constituents have questioned the impartiality of some advisers to the panel and others have pointed out that, in the consultation document, option A was described as being consistently the highest scoring option. Why was there a U-turn and option B chosen? It is right that those decisions should be made by clinicians, but these are legitimate questions from people concerned about the decision.

Andrew Percy: The hon. Gentleman makes an important point, but the decision was not made by clinicians but by commissioners, who have left the eastern side of England between Newcastle and England without a heart unit. Many of my constituents would have gone to Leicester in preference to Newcastle. Now they will probably travel to London or Liverpool.

Jonathan Ashworth: Indeed. Many of the hon. Gentleman’s constituents would have been welcome in Leicester. He is quite right: where do our constituents in the east of the country, between Newcastle and London, go? That is something else that many of my constituents have raised with me.
	I wish to concentrate on the biggest deficiency of the decision, which is the impact on our world-class ECMO service. On Friday, the Secretary of State announced that he would accept the recommendation to shift our ECMO service from Leicester to Birmingham. In Leicester, we have had a brilliant, world-renowned ECMO service for 20 years.

Liz Kendall: I am grateful to my hon. Friend for accepting my intervention, as I cannot speak in the debate because I am a Front-Bench spokesperson on health. Is he aware of the international evidence that shows that Glenfield’s ECMO survival rates for children are 50% to 75% higher than other centres? Those very good survival rates, and the benefits that they bring for children, must be taken into consideration as part of the review.

Jonathan Ashworth: My hon. Friend is right, and she makes the point with her usual eloquence and insight. I pay tribute to the work that she has done and, indeed, the work of other Leicestershire Members—I see that the hon. Member for Loughborough (Nicky Morgan) is in the Chamber—on the ECMO service. I thank the Minister for agreeing to meet a delegation of east midlands MPs, as we had a useful discussion.
	Giles Peek, a consultant paediatric heart surgeon, said last year of the ECMO service:
	“We use it not just after surgery but also to stabilise children and to stop them dying before surgery. We are always full and often take children from other hospitals…Our role at Glenfield as a national reference centre for this treatment is important and underestimated.”
	I fear that Giles Peek’s concerns have come true and that our ECMO service has been underestimated.
	I was grateful that the Minister said in the meeting that the Secretary of State’s decision was based on the Agnes review, but there are other ECMO experts who disagree with that review, so I hope that he will consider publishing the Agnes report. In the few minutes I have left, I shall run through the points that various ECMO experts have made. For example, Glenfield has a world-class facility with more than 20 years-worth of service. There are deep concerns that by uprooting it from Leicester to Birmingham that expertise will be lost along the way. Mr Kenneth Palmer, an ECMO expert, gave a stark warning on Radio Leicester today that as a result of shifting the children’s ECMO service from Leicester to Birmingham lives would be lost, saying:
	“They could never have the same survival rate in another unit if you move it like this. Leicester has one of the highest survival rates in the world, 10%-20% higher than the normal survival rate in the world. To come up to the same skill it will take 5 years at least.”
	He has been joined by other experts who have warned about the impact of shifting the unit from Leicester. Jim Fortenberry, the chair of the ECMO leadership council in Atlanta, when asked whether he agreed that lives would be lost, said:
	“I do agree with that unfortunately. I think the risk is great that by attempting to move and start over that you’d really start the learning curve all over again and the improved outcomes take time and experience to develop, and so by effect starting over on the learning curve you certainly would potentially put lives at stake and it could be very significant.”
	I accept that the Minister takes advice from experts, but given that there is one set of experts making one argument, presumably he receives advice from a different set. If he published his evidence, those of us who are laymen on health policy can try to make our own judgments as those experts scrutinise one another’s work.
	Concerns have been raised about the Birmingham facility and whether it can deal with the new ECMO service. Dr Andrew Coe, a paediatrician from Coventry, said on Radio Leicester this morning that he was
	“not convinced that Birmingham will cope with increased demand following closure”
	of Glenfield. It was suggested to me that if the 80 ECMO nurses at Leicester are not prepared to leave Glenfield, it will take up to eight years for nurses in Birmingham to be trained to the appropriate level of expertise.
	I conclude by mentioning the family from South Cambridgeshire, which the Secretary of State represents, who appeared on Radio Leicester this morning. They said clearly and movingly that the service they received for their little girl was the best they could receive and went beyond what staff needed to do. I hope that the Minister will give us guidance on what is next for Leicester’s ECMO service. I hope that he will consider publishing his evidence, and that we can have some sort of review of, or at least look again at, the shift of Leicester’s ECMO service to Birmingham.

Andrew Selous: I wish to raise the issue of neuroblastoma. I do so as someone who is proud of this Government’s record on the health service and who strongly supports their introduction of the cancer drugs fund.
	Neuroblastoma is an aggressive childhood cancer affecting about 100 new children in the UK each year. It is the most common cancer diagnosed in infancy and is responsible for 15% of cancer deaths in children. There are very few treatments available in the United Kingdom for children with high-risk neuroblastoma, particularly those who have relapsed, and they have to travel abroad for treatment, generally to Germany or the USA.
	I had never heard of neuroblastoma before my constituent, Mr John Macglashan of Dunstable, came to see me in March this year. His two-year-old daughter Lilly has stage 4 neuroblastoma. The Neuroblastoma Alliance, along with the people of Dunstable and the surrounding area with the help of T he Dunstable Gazette , have helped to raise funds to send Lilly for treatment in America. The whole family is going through an enormous ordeal, and I want to relay their experiences to the House, and make four suggestions to the Minister as to how the UK can improve the provision of treatment for children with neuroblastoma.
	First, I know that the Government want high-quality treatment for children with neuroblastoma to be available in the United Kingdom, and I strongly support that. To that end, the Government are participating in a European collaborative research network on neuroblastoma through the Société Internationale d’Oncologie Pédiatrique en Europe That European trial does not appear to adhere to UK ethical standards of offering the best treatment available as a base line for all children meeting the eligibility criteria. I urge the Minister to make sure that the best treatment available is offered as a baseline for all children in the United Kingdom.
	My second concern is that clinical trials in the UK are taking far too long to begin. In March 2010, the Department of Health agreed to commence a new trial to give monoclonal antibody therapy to all children who might benefit from it, but according to the Neuroblastoma Alliance, that has not yet begun. The Government should ensure that this trial commences as quickly as possible.
	Thirdly, it is important that the Government ensure that there is a standard procedure for allocating funds for treatment abroad across all primary care trust areas. That is particularly important as there are currently no NICE guidelines on the subject, which remains important while there is no viable treatment available in the UK. My constituent Mr Macglashan has taken his daughter Lilly to the Memorial Sloan-Kettering cancer centre in New York at considerable personal expense and with huge funds raised by the Neuroblastoma Alliance, a charity that campaigns for children with the condition. Mr Macglashan tells me that in the same hospital there are children from Norway, France, Spain, Italy and Greece, all of whom are being funded by their national health services while his family has had to rely on charity.
	Fourthly, it is important that the best treatment options from abroad, whether from Germany or the USA, should be examined and, where the clinical evidence supports the case, introduced into the United Kingdom as quickly as possible. At the moment, there are too few options available for high-risk neuroblastoma children who fail to achieve a lasting remission after front-line treatment. In the UK, parents see a system that gives up on their children too soon while there should still be hope. Much higher numbers of children are surviving for much longer with the American treatment, and some
	are achieving permanent remission following treatment at the Memorial Sloan-Kettering cancer centre in New York. We need to make sure that that level of expertise is available here in the United Kingdom.
	This is not simply a call for even greater NHS spending than the Government are currently budgeting for, as the costs of prolonged chemotherapy and radiotherapy in the UK are not cheap and have been shown to have less success than the treatments provided in America. It appears that the UK is not spending its health budget as effectively as it could in this regard, and I ask the Government to look again at the issue. The NHS already sends children suffering from cancer for treatment in America—for proton radiation treatment, for example—so no precedent would be set by sending more children for treatment in America and Germany.
	Finally, I ask the Government to look at the training of consultants in neuroblastoma, as there are too few who specialise in this area.

Nicky Morgan: It is a pleasure to speak in this debate and particularly to follow the remarks of the hon. Member for Leicester South (Jonathan Ashworth) about children’s heart surgery at Glenfield hospital in Leicester. In view of the time limit, I will not repeat the issues to do with the Safe and Sustainable review, because those have been well rehearsed by other Members.
	It is no great surprise that all Members, as well as all patients, all staff, all parents and all families, want the best services when dealing with children’s heart surgery. We are talking about very sick young babies and children, and there is no doubt that high-quality services are wanted across the country. At the same time, we have to recognise that in the 21st century national health service there are bound to be reconfigurations. The reconfiguration that has been worked on by the Safe and Sustainable review arises out of what happened in Bristol, and there is a very good reason for what it proposes. As we have heard, there are some serious questions still to be answered about the process and the way in which decisions have been made.
	In the debate in this Chamber in June 2011, I talked about the ECMO—extracorporeal membrane oxygenation —service offered in Leicester, which the hon. Member for Leicester South discussed. It is a world-class, excellent service, and the question is what will happen to it if the children’s heart surgery unit is moved from Leicester to Birmingham. Like the hon. Gentleman, I thank the Minister very much for meeting a delegation of east midlands MPs this afternoon to talk about this. ECMO is a nationally commissioned service and the Secretary of State is therefore required to sign off the move. I understand that he accepted the recommendations of the panel last Friday.
	Those of us who are most interested in this and have been listening to constituents and to consultants and staff at the Glenfield unit have a number of questions to raise with the Minister. I would like to be sure of three things before I can be happy with how the decision has been taken. First, before the Secretary of State signed off the move, was he aware of the misgivings of experts that have been described by the hon. Member for Leicester
	South? Letters are still arriving from international experts. Indeed, since I have been sitting in the debate I have seen a letter that has arrived from the medical director of the Children’s Hospital of Philadelphia. I should like to read out a couple of quotes. The first is from Stephen Conrad, who is chairman of the steering committee of the Extracorporeal Life Support Organisation and who says that
	“moving an ECMO program is non-trivial and amounts to much more than moving equipment and some key personnel. Excellent outcomes that are now characteristic of the Leicester group, whose work was instrumental in the worldwide adoption of pediatric and adult ECMO, would not be maintained following such a move.”

Liz Kendall: I am grateful to the hon. Lady for her work on, and support for, this important issue. Does she agree that this is not simply a matter of moving the machines but also about the expertise and skills of the staff, which would not be easy to move? Leading international experts on ECMO say that it could take between five and 20 years for the excellent level of service that is available in Glenfield to be made available anywhere else in the country.

Nicky Morgan: I am grateful to the hon. Lady; she is absolutely right. The hon. Member for Leicester South referred to Kenneth Palmer, who was retained to give his expert advice to the Joint Committee of Primary Care Trusts on the move. Since the decision was made on 4 July, he has said:
	“You will take over 20 years of experience from one of the world’s absolute best ECMO units and throw it away and then to rebuild it in another place and probably it will take at least 5 years to have some kind of quality and probably 20 years to come back to top quality, if it’s ever possible.”
	As the hon. Lady said, it is about the staff. Of course the machinery is important, but what has been built up in Leicester, and what it is most renowned for, is the expertise of its consultants, nursing staff, and all the other staff. That is what people particularly rely on. In addition, Leicester has the only paediatric mobile ECMO unit, which is often called out to fly by helicopter to other parts of the country to retrieve patients and take them back to Leicester. I hope that the Secretary of State and the JCPCT were aware of that when they made their decision.
	My constituent, Mrs Edith Felstead, who wrote to me and talked about the risk of moving the service, says that survival rates at Glenfield are 20% better than in the rest of the world. The point that I made last year and still want to make is that we have an excellent, internationally renowned service, and if we move it, we must be sure that we are doing so to obtain better outcomes. Will the Minister tell me what advice was given to the JCPCT about the likely outcomes if the move were made?
	The rather hefty tome that was published to help the JCPCT to make its decision on 4 July, refers to the secretariat being able to provide “reasonable assurance” that paediatric respiratory ECMO could be transferred safely to Birmingham. I am concerned about that phrase. What assurances have been given? In particular, if the move goes ahead and has to be implemented, what will happen if it then becomes clear in the course of preparing for the move that the service cannot be safely moved and we need to undo some of what has happened as a result of the review?
	As the hon. Member for Leicester South said, two narrow questions could be independently reviewed in relation to the Leicester move. I very much hope that following the meeting that we have just had and this debate, the Minister will agree to such a review. I would like to know what advice was available to the Secretary of State and to the JCPCT and the Advisory Group for National Specialised Services before they made their decision.

Stuart Andrew: I am grateful for the opportunity to speak in this debate, Mr Deputy Speaker. May I offer you my congratulations on the honorary degree that you received yesterday from Swansea university?
	I recognise that I may repeat many of the things that have been said, but this is such an important issue for constituents in Yorkshire and Lincolnshire that I make no apology for doing so. I am going to talk about the Safe and Sustainable review as well. We have received a number of e-mails from charities yesterday, one of which said:
	“As some MPs look to reignite”
	the debate about changes to children’s heart units
	“we urge MPs to think about the children.”
	Frankly, I found that rather offensive, because throughout the whole campaign I have only ever thought about the children.
	When I worked at Martin House children’s hospice, I saw the effect on families when they were driven apart because the poorly child had to be a long distance away. On my visit a week or so ago to the unit in Leeds, I met a family who live in Sheffield. They brought their baby who was a few days old into the unit when the baby suddenly went very blue. Thankfully, because of the excellent work at the unit, that baby’s life was saved. That child was described as “marginal” in the review meeting on 4 July. That is not my description, but that of the decision makers. That is a shocking statement in my opinion. I also met another family who live in Sheffield. The father is making three trips a day between Leeds and Sheffield because there are other siblings at home. How on earth are such people expected to travel three times a day up to Newcastle?
	I recognise that the review has been independent of Government, but I have grave concerns over the way in which it has been run. I support a review, because I want the best services for our children. I was grateful for the Minister’s comments earlier, when he said that the call-in process means that the matter will go to an independent panel. I would be grateful for clarification of whether that panel is independent of the JCPCT.

Simon Burns: May I reassure my hon. Friend that the Independent Reconfiguration Panel is nothing to do with the JCPCT, my right hon. Friend the Secretary of State or me? It is an independent organisation that is there to look at reconfigurations across the country that are referred to it by my right hon. Friend following an oversight and scrutiny committee writing to him.

Stuart Andrew: I am extremely grateful to my right hon. Friend for that clarification. I hope that the independent review body will look at the issues that I raise.
	Logical health planning clearly dictates that services should be based on where the population live. Doctors should travel to where the patients are, rather than the other way around. Even the British Congenital Cardiac Association has said that:
	“Where possible, the location of units providing paediatric cardiac surgery should reflect the distribution of the population to minimise disruption and strain on families.”
	After all, it is not buildings that perform operations, but the doctors and surgeons within them. That definition seemed okay in the case of Birmingham. The review stated:
	“The Birmingham centre should remain in all options due to the high level of referrals from the large population in its immediate catchment area.”
	Why on earth does the argument about the large immediate population not apply equally to Leeds?
	The independent analysis of patient flows states that many of the people in west and south Yorkshire and in Lincolnshire will probably go to Birmingham, Liverpool or even London instead. The JCPCT reaches the figure of 403 surgical procedures for Newcastle on the basis of only 25% of the patients going there. Even that is doubtful. How was the figure of 25% arrived at?

Andrew Percy: It is very convenient that the 25% figure gets Newcastle just over the 400 mark. However, my constituents in east Yorkshire and north Lincolnshire will not travel to Newcastle at a rate of 25%. They will go straight up the M62 to Liverpool or head south to Birmingham or even London, which are much easier to get to.

Stuart Andrew: My hon. Friend is right. I am sure that that is the case for constituents across Yorkshire and the Humber.

Greg Mulholland: I am happy to be working so closely with my hon. Friend on this matter. When all the evidence is considered, is not the reality that Leeds is being sacrificed simply to allow Newcastle to achieve a level of operations that it might not even achieve? That is no reason to close a good unit.

Stuart Andrew: I could not agree with my hon. Friend more.
	The decision flies in the face of a fundamental aspect of the NHS constitution: patient choice. The JCPCT asserts that Newcastle could reach the minimum number of procedures if parents are “properly managed” to go to there. That is simply unacceptable. The whole point of patient choice is that people decide where they want to go.
	As my hon. Friend the Member for Leeds North West (Greg Mulholland) said, the review ignored a petition of 600,000 people, counting it as only one response, when 22,000 text messages in support of the Birmingham unit were counted as 22,000 separate responses. Why was that?
	The scores in the review were allocated to four bands. Each of the points from one to four were multiplied by the weighting. That gave 286 points to Newcastle and 239 points to Leeds. However, there was no clarification of how the figures had been arrived at. Also the figures were not definite, but were rounded up or down, which may have made a huge difference to the outcome.
	As has been mentioned, clinical experts at the BCCA, the Bristol inquiry, the Paediatric Intensive Care Society and the Association of Cardiothoracic Anaesthetists all say that surgical centres should be chosen on the basis of their having paediatric services all on one site. That is something that we enjoy in Leeds, which has a wonderful children’s hospital with all the services that are needed. On meeting such children, it is clear that they need the support not just of heart surgeons, but of other experts. In Newcastle, the extra support will be some 3 miles away. There will therefore be a worse service for people who live in and around Yorkshire, not the world-class service that we all want.
	There is much more detail that I would like to go into. I sincerely hope that we will have a Back-Bench debate on this issue when we come back in the autumn, because it is of grave concern to hundreds of thousands of people in the Yorkshire region. We will not give up our fight to save our unit.

Matthew Offord: I wish to raise the issue of wet age-related macular degeneration and the treatments that are available.
	The condition usually affects the sight of people from the age of 60, although it can affect people at an earlier age. AMD is the most common cause of sight loss in the western world. In the UK, more than 500,000 people have the condition and about 250,000 people are registered as visually impaired. Because people are living longer, the number of people who are affected by AMD is increasing.
	Although the condition causes central vision loss and can have a devastating impact, it does not lead to complete blindness as sufferers retain their peripheral vision. Unfortunately, there is no known cure, but drugs are available that can slow the growth of blood vessels in the eye. Such anti-vascular endothelial growth factor medicines prevent blood vessels from forming or growing. Three drugs have been used in the treatment of wet AMD: Macugen, Lucentis and Avastin. It is the latter two drugs with which my speech is concerned.
	Fundamentally, what is the difference between the two drugs? At first glance, the answer is the cost. Lucentis costs about £700 an injection, while Avastin costs £60. The bigger answer is that Avastin is not officially approved for eye treatments. Lucentis gained its European Medicines Agency approval in 2007. It is officially approved for use in eyes and is the treatment recommended in England and Wales by the National Institute for Health and Clinical Excellence. The certification is based on extensive trials that show that is safe and effective for all lesion types in wet AMD. The trials have shown that it stabilises sight in more than 90% of cases and improves sight in 40% of cases.
	The cheaper Avastin has not been approved by the EMA for use in treatments of the eye because it has not gone through the proper clinical trials. It has been approved as a treatment for colorectal cancers, and is therefore readily available. When used for colorectal cancers, the drug is injected into a vein in the arm. When it is used for the treatment of wet AMD, it is given into the eye.
	The findings of two trials comparing Avastin and Lucentis have been published recently. Those are the comparison of age-related macular degeneration treatments trial, known as CATT, which was carried out in the United States, and the inhibit VEGF in age-related choroidal neovascularisation trial, known as IVAN, which was carried out in the UK and was funded by the National Institute for Health Research. The IVAN trial, which was NHS funded, involved 610 patients in 23 hospitals. It was one of the largest research projects studying eye diseases in the UK. The one-year results were presented at an international conference in May this year and have been accepted for publication in the peer-reviewed journal, Ophthalmology.
	The greatest debate about the differences between the two drugs is likely to be over their safety when used to treat wet AMD. Academics say that, overall, both drugs are extremely safe. My contention is that it is likely that cost pressures on the NHS will lead to increased use of Avastin. The IVAN researchers estimated that if the NHS were to substitute Lucentis for Avastin across the UK, it would save £84.5 million each year if 17,295 eyes were treated.
	However, I am aware of the financial environment in which pharmaceutical companies operate. Like other industries, they manufacture products that must be sold at a profit, but in contrast to manufacturers in other industries their research and development costs are prohibitive. That means that they must make money on their investment. I recognise that they must not only regain their expenditure through profit but achieve profits to cover all the drugs that fail to get on to the market.
	There has been criticism of NICE’s failure to recognise and adopt innovative new medicines. The UK is a world leader in medicines research, development and manufacture, but it is one of the slowest countries to enable patients to have access to innovative treatments. Avastin fits into that classification. I do not seek the Department’s licensing it immediately, but I call for the Government to establish an independent appraisal of it for use in ophthalmology. Clinicians are already using it off-label, so that would not be a leap in the dark. The savings that there would be for the NHS if the drug did work have already been quantified. However, if it is not safe, we must act to ensure the public’s health. I therefore ask the Minister to consider my request.

Priti Patel: My comments will focus on the treatment of one GP in my constituency and his patients in Kelvedon, and on the state of health services in Witham town.
	With the Government rightly empowering patients and medical practitioners, it is deeply alarming to see how one GP in my constituency is being treated. Dr Conor Macnamara has served the people of Kelvedon for a quarter of a century and is currently a salaried GP at the Brimpton House surgery in Kelvedon. He has been a stalwart of our local community, and whole families throughout the locality respect and trust him. He has upheld the values of the NHS on the front line and enthusiastically supported local residents.
	Despite Dr Macnamara’s strong record, the primary care trust, which is now called NHS Mid Essex, and the GP principal at Brimpton House surgery, Dr Alsayed,
	have decided to end his employment and stop him treating local patients. They did so at the end of last year without consulting his patients, and they issued a statement informing his patients of the decision before Dr Macnamara himself was formally notified of it.
	The decision to remove Dr Macnamara, and the way in which it was carried out, have caused considerable consternation among local residents. They are up in arms, and they have signed a petition objecting to any attempt to remove this long-standing family doctor from Brimpton House surgery. Yesterday, alongside the patient action group, they handed in a petition and delivered a letter to Dr Alsayed, reiterating their wish to see Dr Macnamara reinstated. I pay tribute to them for their campaign and remain extremely disappointed by the lack of engagement by the PCT and Dr Alsayed in addressing local concerns, and by their failure to address Dr Macnamara’s concerns. In my view, that is a classic example of NHS bureaucracy overriding patient choice. I hope that my right hon. Friend the Minister will look into the matter and help us find a good resolution that will lead to Dr Macnamara’s reinstatement.
	As well as ignoring patient choice in Kelvedon, NHS bureaucrats have neglected health provision in Witham town. It is a growing town, and the local community is being overlooked in the provision of health services. We have a growing population, and the demand for new health service provision is reaching breaking point. Our population is increasing and more and more new homes are being built, so the provision of good-quality local health services is vital. Instead of investing in local services, the PCT has shamelessly spent hard-pressed taxpayers’ money on more managers and administrators.
	The number of patients registered at the four GP practices covering the town and surrounding villages has reached almost 30,000. Those patients are covered by just 13.5 whole-time equivalent GPs, which makes more than 2,000 patients per GP. That is 40% higher than the 2011 national average of about 1,600. Local people need more GPs instead of managers, and I hope that my right hon. Friend the Minister can offer us some advice as local health campaigners. We want to press the new clinical commissioning groups to increase local GP provision. Progress must be made, and my constituents in Witham would welcome any intervention and encouragement that he can provide to nudge the process along, particularly given the Government’s reforms.
	The Government have rightly prioritised the NHS, and their reforms will help save it in a time of financial uncertainty. I hope they will now do everything possible to ensure that their commitment to support patient choice and invest in front-line health services can be delivered in Witham, to avoid a health crisis and bring much-needed and long-overdue benefits to my constituents.

Simon Burns: This has been an interesting and diverse debate, giving hon. Members an opportunity to raise a range of different subjects affecting their local communities and the health and well-being of their constituents. If there has been a main theme, it has been the Safe and Sustainable review of paediatric heart surgery. I fully recognise the strength of feeling and emotion on that difficult and sensitive subject, which is why so many Members have
	talked about it. They have included the hon. Member for Leeds North West (Greg Mulholland); the hon. Member for Hammersmith (Mr Slaughter), who mentioned the Brompton hospital in London, which is part and parcel of that review; the hon. Member for Leicester South (Jonathan Ashworth), who took interventions from the hon. Member for Leicester West (Liz Kendall); and my hon. Friends the Members for Pudsey (Stuart Andrew), for Colne Valley (Jason McCartney) and for Loughborough (Nicky Morgan).
	I fully accept that the reorganisation of children’s cardiac services is a matter of real concern for the families involved, as indicated by the strength of feeling shown in the contributions of all the Members who have taken part in the debate. I know that some families have been disappointed by the outcome of the JCPCT’s recent decision. As hon. Members will know, children’s heart surgery has been a subject of concern for more than 15 years. Clinical experts and national parents groups have repeatedly called for change, and there is an overwhelming feeling that change is long overdue.
	As passionately as people want to defend their local hospitals, it is far more important to ensure safety and quality of care for all children with congenital heart disease. We must ensure that those children continue to receive the very best care that the NHS can deliver, and I know that no Member would disagree with that overarching principle. That was what the NHS Safe and Sustainable review was aimed at, and as I have told many Members over the past 22 months, it was wholly independent of Government.
	The review was led by clinicians and had the support of the Royal Colleges and national charities. Its conclusions were clear: for children with congenital heart disease to receive the very best care, specialist surgical expertise needs to be concentrated in a smaller number of centres. That will mean that surgeons have sufficient clinical work to maintain and develop their skills; that they can provide those services around the clock; and that they can train and develop the next generation of surgeons. I must stress that the JCPCT’s decision is not about closing or cutting back on children’s heart services—quite the opposite. It is about ensuring that the whole range of children’s heart services can deliver the very best care now and in future.
	I thank in passing my hon. Friend the Member for Loughborough and the hon. Member for Leicester South for meeting me earlier this afternoon to discuss the important issue of ECMO and how it directly affects Glenfield hospital in Leicester.

Keith Vaz: I am afraid other duties in the House prevented me from being at the meeting. Had I been there, I would have supported what the hon. Member for Loughborough (Nicky Morgan) and my hon. Friend the Member for Leicester South (Jonathan Ashworth) said.

Simon Burns: I am extremely grateful to the right hon. Gentleman. Not only am I sure he would agree with every word that my hon. Friend the Member for Loughborough and the hon. Member for Leicester South said, but I have considerable sympathy with him, as he was unable to attend the meeting owing to other pressing parliamentary duties in his role as Chair of the Select Committee on Home Affairs. To be even fairer to the right hon.
	Gentleman, the meeting was originally planned for 3 pm or 3.15 pm, but unfortunately, neither my hon. Friend, the hon. Gentleman nor I would have been able to attend because we were at that moment in the Chamber.
	I understand from the nature of our discussions, as they will, that this is a difficult issue, because there are a number of complicated parts to the problem. I hear what they and other hon. Members have said about the Safe and Sustainable review, but I stick to my original position. The review is independent and is carried out not by the Government, but by the JCPCT. It would be inappropriate for me to become directly involved, to take sides or to pass comment because it would be felt that I was interfering. If hon. Members’ local authorities disagree with the decisions or recommendations of the JCPCT, their overview and scrutiny committees can write to my right hon. Friend the Secretary of State for Health to express their disagreement with the decision as it affects their local community or local hospital, and to request that the matter be referred to the independent reconfiguration panel, so that it can consider it independently and come up with a decision.
	As my hon. Friend the Member for Colne Valley said, his local authority has today done just that. It may be helpful to him if I explain the procedure. My right hon. Friend the Secretary of State receives the representations and communication from the local authority overview and scrutiny committee specifying that it believes that the decision and recommendation as they affect the local hospital—Leeds, in my hon. Friend’s case—are wrong. The overview and scrutiny committee then asks my right hon. Friend whether he will refer the matter to the independent reconfiguration panel. I do not want to prejudge, but it is almost certain that my right hon. Friend will refer the matter. It will be then be up to the IRP, which is independent, to look at the recommendation and the criticisms made by the overview and scrutiny committee, and to reach a conclusion, which will be an independent conclusion, on whether it agrees with the recommendation or the criticisms of it and perhaps of the procedures involved. The IRP will then make my right hon. Friend aware of its independent view of the complaint.

Jason McCartney: Will the Minister clarify the time scale of the procedure he has described and also tell us who has the final say?

Simon Burns: It is difficult to give a time scale for this reason: as soon as my right hon. Friend receives representations from the overview and scrutiny committee, he will consider as quickly as he can whether to make a referral. As I have said, in the life of the IRP, every request for a referral has been granted—that is certainly true of my right hon. Friend’s time in office, but I believe it is also true of previous Secretaries of State under the previous Government. It is up to the IRP. I know of one example of my right hon. Friend requesting that the IRP respond within a certain time frame, but that was on a single issue. It is possible, with regard to the Safe and Sustainable review, that a number of referrals could be made by different OSCs in relation to the recommendations—I do not know but it is a possibility.

Stuart Andrew: Will the Minister give way?

Simon Burns: I will give way once more, but then I will have to make progress, because I only have 10 minutes to respond to the whole debate.

Stuart Andrew: Will the independent panel have the power to request all the documentation that the Safe and Sustainable review and the JCPCT have been looking at? Will everything be released so that it can look at the evidence in detail?

Simon Burns: The IRP?

Stuart Andrew: Yes.

Simon Burns: I think I can assure my hon. Friend that the IRP will have available to it all the evidence, in all shapes and forms, to help it to form its final opinion of the complaint referred to it. I hope that that reassures him. I say to my hon. Friend the Member for Loughborough and the hon. Member for Leicester South that the same can apply with regard to the decision about ECMO. I have no doubt that Leicester city council will give consideration to that.
	I shall briefly respond to the remaining issues. My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) made several extremely interesting suggestions. Some of them might not be in line with current Government thinking, but I shall certainly refer her ideas and views to the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), who deals with our alcohol strategy. Similarly, my hon. Friend the Member for South West Bedfordshire (Andrew Selous) raised an important issue, and again I will refer it to the Under-Secretary of State.
	The hon. Member for Mitcham and Morden (Siobhain McDonagh) mentioned the potential reconfiguration at St Helier hospital. As she will know, the proposals are still being worked on. There has not yet been a consultation process, but the decisions have been taken locally by the local NHS. I trust that, if and when there is a consultation process, she will get involved.

Siobhain McDonagh: Absolutely.

Simon Burns: I thought she would say that. That is very good. After the consultation, the due processes of reconfiguration can move forward.
	My hon. Friend the Member for Hendon (Dr Offord) asked about Avastin. A study is being done into its effects. We are following that closely, and when we find out more we will consider the matter and potentially reach a judgment, but I cannot give him any commitments at the moment.
	Finally, I turn to my constituency neighbour, my hon. Friend the Member for Witham (Priti Patel). I am sorry to hear about the problems that she highlighted on behalf of her constituents. I do not want to disappoint her, because she is my neighbour and I have to live with her on a weekly basis, but given the background to the case, I think it is a matter for the GP practice as the employer of the GP whom she mentioned. I encourage her to engage with Mid Essex PCT, even though it has no direct powers or role in this matter, and the clinical commissioning group in the mid-Essex area, because they are best placed to address the concerns about the provision of services for her constituents, which I know she is fearless in defending, protecting and promoting.

Nigel Evans: I thank the Minister. I wish him and those Members not staying for the other debates a happy and productive recess. We now move to a short debate on foreign and commonwealth affairs, after which we will proceed to a debate on the environment, food and rural affairs. Members listed under other topics will then be taken in the general debate. We still have the five-minute limit on speeches.

FOREIGN AND COMMONWEALTH OFFICE

John McDonnell: Once again I wish to raise the issue of human rights and the death penalty in India. I pay tribute to four organisations—Kesri Lehar, Liberation, Amnesty International and Human Rights Watch—that have continued to expose the Indian Government’s failure to address human rights abuses effectively. Kesri Lehar launched the “Wave for Justice” campaign, along with a petition, which has now been signed by more than 100,000 people, to seek a full debate in Parliament on the issue, which I hope we can secure later in the year.
	I want to raise three issues of concern. The first issue is the historic failure of the Indian Government to bring to justice those who perpetrated the massacre of the Sikhs in Operation Blue Star in 1984, which started with the attack on the Golden Temple in Amritsar and resulted in the murder of hundreds of thousands of Sikhs in the following decade, and was described as Indian’s hidden genocide. Despite various commissions of inquiry into abductions, disappearances, extra-judicial executions and secret cremations, Amnesty’s latest report confirms that the Indian Government have failed to hold the perpetrators to account. In 2004, on the 20th anniversary of the massacre, I launched a report in this House called “1984: Sikhs’ Kristallnacht”. We called for an independent commission of truth and justice, under the auspices of the United Nations, to investigate the slaughter. Since then there has been no progress and the Sikhs still await justice.
	What is even more galling, however, is that two individuals—Jagdish Tytler and KPS Gill, who are both accused of playing leading roles in the human rights violations in 1984 to 1995—may well seek to visit Britain for the Olympics in their capacity as Olympic officials for India. It would be a travesty of justice and cause deep offence to the whole of the Sikh community in the United Kingdom if these brutes were allowed to enjoy this country’s hospitality.
	The human rights abuses go on. Human rights NGOs have confirmed that human rights violations against minorities continue today, including against the Sikhs. Human Rights Watch’s latest report dealt with custodial killings and police abuses, including torture. On average, 1,500 people a year are dying in custody in Indian prisons and police stations, while rape is used as a form or torture. For 18 years the Indian Government have denied the UN rapporteur on torture access to India. Amnesty now reports that over the past two years 30 human rights defenders have been targeted for abuse by state and non-state organisations, with eight people being killed as a result. Meanwhile, the Indian Government have failed to repeal the laws that afford state impunity to human rights abusers. Indeed, impunity seems to be common for the perpetrators of human rights abuses in India. That is not acceptable by any standards.
	The ultimate violation of human rights, however, is to take a person’s life. That is why there was such shock and anger at the Indian Government’s threat—made only months ago, after an eight-year hiatus—to implement the death penalty against people such as Professor Davinder Singh Bhullar and Balwant Singh Rajoana. Professor Bhullar was convicted only on a confession
	that was obtained by torture and later retracted. Balwant Singh Rajoana has already served 17 years on death row and has suffered enough. The threat of capital punishment for those individuals has been lifted for the time being, but now two thirds of the world has renounced the death penalty. I say as a friend of India that it is time India did so too.
	I appreciate what both the last Government and this Government have done in making representations to the Indian Government over the years. I also pay tribute to the work that the Minister has done in pressing the Indian Government on these issues. However, I once again urge the Government to use our bilateral talks, and the EU-India human rights dialogue, to call on India to take decisive action to protect human rights and, in particular, to abolish the death penalty. It is time India addressed this issue. India is the largest democracy on the globe, yet it stands alone in the developing world in still supporting the death penalty. India should adhere to human rights and, at the same time, ensure that capital punishment is no longer a stain on the country.

Paul Flynn: The professionalism, valour and courage of our soldiers who have served in Afghanistan and those serving there now are as distinguished as any in our long military history. Some of our allies have already decided to withdraw their troops. They are not the nations that were not enthusiastic about the war, but those that have paid huge costs in blood and treasure. Canada withdrew its combat troops after a debate in its Parliament that was supported by every party. The Netherlands has also done so, and we now know that Australia and France intend to bring their troops home early.
	The United Kingdom has lost 422 troops, and we have spent £20 billion, but that is only part of the cost. We must also take into account the number of troops who return from Afghanistan broken in body and in mind. Figures from America show that more of its veterans from Afghanistan take their lives after combat than die in combat. The same applied to our figures from the Falklands war. We know that the dying will continue.
	A case in Pembrokeshire involved a soldier who had suffered grievously in Afghanistan. His death is not counted among the 422 casualties, however. In Afghanistan, he was shot twice and involved in two separate incidents involving improvised explosive devices, but his loved ones explained that the experience that haunted him was holding his best friend, who had lost a number of limbs in an explosion, and watching as the life retreated from his eyes. It was that experience that drove him to take his own life.
	There are powerful reasons for saying that we are continuing to order soldiers to risk their lives for the cause in Afghanistan, but I do not believe that a case can be made for doing so any more. A recent briefing said that we needed to get all our equipment out of Afghanistan at enormous cost, because we did not want to see the Taliban riding round in British tanks in five years’ time. However, having gone into Afghanistan when it was ruled by the Taliban and engaged in a civil
	war, the likelihood is that, by the time we leave, there will be another civil war and that it will be ruled by the Taliban once again.
	For 10 years, we have heard optimism being expressed by all Governments, along with exaggerations of success and dismissals of the failures that mounted up, year after year. It was not necessarily a mistake to go there, although no British interests were threatened in 2001. It was, however, a terrible mistake to go into Helmand province. In our first five years in Afghanistan, only two of our soldiers died. Then, we provocatively stirred up the hornets’ nest in Helmand, in the foolish and mistaken belief that not a shot would be fired. Our operations in Helmand were described in the House at the time as being as futile as the charge of the Light Brigade, but we have now lost three times as many troops in Helmand as were lost in that charge.
	It is a dereliction of duty for the House not to debate the withdrawal of our troops from Afghanistan. We know that the people of this country are strongly in favour of such a withdrawal. In a recent by-election, a candidate from a minority party with only one policy—withdrawal from Afghanistan—gained 56% of the votes and humiliated all the other parties. We also know that 80% of the public want our troops to withdraw now, yet we are being distracted by the bread and circuses of all the events taking place this year, and we cannot find a moment in our parliamentary diary to discuss whether we should bring our troops home before we reach the point that Senator Kerry described when he was an officer in Vietnam in the final days of that war. He spoke of asking the agonising question: who will be the last soldier that I will order to die for a politician’s mistake?

Keith Vaz: I had hoped that, after the election of President Hadi in Yemen, I would no longer need to raise the situation in that country. Sadly, however, the situation has deteriorated even further since the election. Only last week, 22 people died in a suicide bomb attack in Sana’a. That attack followed a number of others perpetrated by al-Qaeda in the Arabian Peninsula. I remain deeply concerned that, even though the old regime has gone and President Hadi has been elected, there is still a major security problem in this beautiful but troubled country.
	As the House knows, I was born in Yemen, and I spent the first nine years of my life there. I have the pleasure and privilege of chairing the all-party parliamentary group on Yemen. I have not been able to visit the country over the past two years because of the security situation; so if it is bad for someone such as me and other Members, it is very bad for people in Yemen.
	I am delighted to see at the Dispatch Box the Under-Secretary of State for Foreign and Commonwealth Affairs, the hon. Member for North East Bedfordshire (Alistair Burt), and I want to pay tribute both to the Foreign Secretary and to him for all the good work they have done in ensuring they keep a dialogue going with the Yemeni Government and the Yemeni authorities. The Minister met last Thursday, as did I, Dr Abu Bakr al-Kurbi, the long-standing Foreign Minister of Yemen, and I know that useful discussions were held about the situation.
	I am very pleased that Nicholas Hopton has taken over as our ambassador in Sana’a, although the difficulty of having an embassy there is recognised by the fact that this is truly a hardship post, and it is time limited, which is something we do not do to many of our embassies all over the world. The first issue, then, is security. What does the Minister have to say about the security situation in Yemen? What can we do to help the new Government? What can we do to ensure that they have the equipment and support they need?
	A few years ago, spoke of the need for one scanner at Sana’a airport, and I recently tabled a question asking whether the scanner had arrived, two years later, and was told that the information could not be released because it was not in the public interest to do so. I then put in a freedom of information request. I do not think it is a big deal to tell an MP whether a scanner that was promised two years ago has arrived at Sana’a airport. I hope that the Minister can provide that information in his reply.
	The second limb of any discussion about Yemen is the humanitarian situation, and I want to pay tribute to my near constituency neighbour the Minister of State, Department for International Development, the right hon. Member for Rutland and Melton (Mr Duncan) for all the work he has done. He has attended a number of the Friends of Yemen conferences, and £2.5 billion has been pledged over the last few years. I know that our Government have given £31.7 million in humanitarian aid. It remains the case that 500,000 people are displaced as a result of the situation in Yemen, and it remains the case that 50% of the Yemeni population do not have access to clean water and sanitation. It remains the case, too, that the vast majority of Yemenis live on less than £1.29 a day. This situation can only help to feed the ambitions of al-Qaeda in the Arabian peninsula.
	All I ask from the Minister—as I said, Ministers have continued the good work of Ministers under the last Government—is that we continue our strategy and our plan to help the Government of Yemen, and that we give them whatever support they need. We must be cautious about one aspect: when we have international conferences, many countries—the Saudis, for example—pledge a lot of money, but I do not know whether it is actually paid. We must ensure that, having made a pledge, the donors ensure that the money reaches the people who matter—the people of Yemen.

Alistair Burt: I thank the three colleagues who have spoken briefly and succinctly, but equally powerfully, in each set of comments. I am not time limited, but I will do my best to be as brief as possible, fair in responding to what colleagues have said and fair to those who are waiting to speak. I shall deal with colleagues’ contributions in order.
	The hon. Member for Hayes and Harlington (John McDonnell) raised the issue of the death penalty in India and some particular cases. One of the advantages of having a deep and wide-ranging bilateral relationship with India is that it allows us to have frank and open conversations about all areas of interest and concern. Where we have concerns about human rights issues, we have made them clear to the Government of India.
	I know that the death penalty is of particular concern to Members and their constituents, as the hon. Gentleman made clear. Both my right hon. Friend the Foreign Secretary and the Minister of State, Foreign and Commonwealth Office, my hon. Friend the Member for Taunton Deane (Mr Browne), who has responsibility for matters relating to India, receive a significant amount of correspondence on the subject.
	We have made our opposition to the death penalty in all circumstances clear to the Government of India on many occasions, urging them to formalise the now eight-year de facto moratorium with a view to eventual abolition. The decision earlier this year to proceed with the execution of Balwant Singh Rajoana was therefore deeply concerning. We took every opportunity to express that concern to the Government of India, and I am grateful for what the hon. Gentleman said about our efforts. According to the note I have here, the issue of the death penalty and particular cases have been raised deliberately on 11 occasions in the past 12 months. We are obviously pleased that a stay of execution for Balwant Singh Rajoana was announced on 28 March so that the President could consider an appeal for clemency.
	Much of the correspondence received by my ministerial colleagues refers specifically to that and a number of other cases relating to Sikhs, and to events in the state of Punjab in recent decades. Our principled opposition to the death penalty is of course separate from the specifics of cases in which we must be careful to avoid interference in India’s judicial process, just as we would wish other Governments to respect our own. However, the UK is active in encouraging an improvement in the treatment of minority communities in India. The British high commission in New Delhi has discussed minority community issues with the Indian National Commission for Minorities and with various other state-level authorities, and I assure Members that those discussions will continue.
	In addition to such bilateral exchanges, the main forum for discussing concerns such as those raised by the hon. Gentleman is the annual EU-India human rights dialogue, the next round of which will take place soon. It allows a frank exchange of views, and, crucially, it is a two-way process. The matters that the hon. Gentleman has raised today will certainly be raised again in the course of that dialogue.
	During the United Nations Human Rights Council’s universal periodic review of India in May, we urged it to maintain its de facto moratorium on the death penalty. We asked about the Indian Government’s response to concern about India’s security legislation, and also noted concern about reports of a significant number of cases of torture by police and security authorities. We recommended that India expedite the ratification of the convention against torture and its optional protocol, and adopt robust domestic legislation to that effect.
	The hon. Gentleman also raised the issue of the Olympic games, and asked specifically about accreditation. We do not routinely comment on individual cases, but our policy is clear: accreditation will be refused to any individual who may present a safety or security risk or whose presence at the games or in the UK would not be conducive to the public good, and it will be refused if there is independent, reliable and credible evidence that an individual has committed human rights abuses.
	The hon. Member for Newport West (Paul Flynn) made a familiar but none the less passionate and heartfelt plea in relation to those who are serving in Afghanistan, repeating concerns that he has raised regularly about what he believes to be their overlong presence there. There is no doubt that when he speaks about the circumstances affecting individual soldiers and what they have experienced, either personally or through what they have observed with others, he speaks movingly and with heartfelt compassion, and no one could deny the force of what he says. He constantly raises the questions “What has it been worth?” and “Is it ever worth it?” It would be wrong for me to stand at the Dispatch Box and not give a positive answer to those questions, or rebut, as gently as I can, some of the hon. Gentleman’s worst fears.
	As I have said to the hon. Gentleman before, I believe that there are genuine signs of progress. We know that there are still difficult days to come, but let me offer an answer to those who feel that absolutely nothing has been achieved. The number of district governors has risen from five in 2008 to 12. Eight of Helmand’s 13 districts, and the municipality of Lashkar Gah, are now either in transition or about to embark on it. That means that their security will be no longer the responsibility of UK or international forces but that of Afghan forces, which are gradually taking more and more responsibility for their own areas. Tranche 3 of the transition will see some 75% of the population of Afghanistan covered by their own forces, which have been trained by the international forces in order to meet the security needs of the people in the future. That will allow the UK and international forces to retreat from their international obligations in 2014, as has long been planned. I also say to the hon. Gentleman that we have no sense that we are not going to stick to that timetable, which truly matters for the future security of those in Afghanistan.
	Some 145 schools are open, an increase of 79% since 2008. There are 89,000 male students in Helmand province and 29,000 female students. There are women teachers, too. All these things did not happen before, which is why the people of Afghanistan are so concerned that the progress must be maintained. We can ensure that only by sticking to the timetable.
	The series of international conferences in the past year or so—Bonn, Chicago, Tokyo, Istanbul—have all been designed to demonstrate that, although combat troops will be leaving in 2014, the international community’s commitment to Afghanistan will continue. Chicago was about how the future security will be guaranteed. Tokyo was about international development support; we are committing to give the same level of support as now until 2017, after which time the situation will be reviewed. All these assurances are absolutely essential for Afghanistan’s people as they take more responsibility for their own future.
	That future will have been bought by the sacrifices of the people to whom the hon. Gentleman referred so movingly. I disagree with his view that it has not been worth it, however. Each individual life lost, and each individual life ruined by wounding or pain, is a tragedy, but it has not been for nothing, and there are plenty of people in Afghanistan who recognise that and know
	that what they will have in the future will have been dearly bought for them by others. They are determined to make something of that.
	No one pretends there will not be difficult days to come, but if we consider the protection of women, and their situation, their human rights and their opportunities for the future, we can see that they are better now than they would have been had international forces not been involved, and had UK forces not made the sacrifices they have made.
	Finally, let me turn to the comments on Yemen of my friend, the right hon. Member for Leicester East (Keith Vaz). I would have begun by painting a slightly brighter picture. The security situation is not easy, but since the election of President Hadi there have been positive signs in a number of areas. The national dialogue—the essential political process that needs to go forward—is being engaged upon, and the President has been adept in handling the armed forces, who have sometimes been at odds with authority and each other.
	Although the security situation is difficult, there are positive signs on where Yemen is going, and the degree of confidence displayed in President Hadi, not least by the Friends of Yemen, has been striking. I would therefore maintain that things are better than they were—and the right hon. Gentleman would certainly find that the ambassador would say that, too.
	Let me briefly run through the major areas the right hon. Gentleman discussed. A clear priority for the President has been removing the malign threat posed by al-Qaeda in the Arabian Peninsula, and re-establishing security throughout the country. In his inauguration speech, the President was clear about his determination to address the instability. Since then, we have witnessed great achievements by his security forces in the south, with the retaking of towns across Abyan province from AQAP, but those successes have not come without sacrifices, including those resulting from the appalling attack in Sana’a on 21 May, the assassination of the southern military commander on 18 June, and, only last week, an attack on young police cadets at the police academy in Sana’a.
	AQAP is on the back foot, but it retains the capability to conduct attacks both inside and outside Yemen. Restoring security and tackling the threat of violent extremism emanating from Yemen is a top priority for this Government, and I assure the right hon. Gentleman that we are committed to the stability of Yemen. That commitment is undiminished, and we will continue to work with the Yemeni Government in their fight against AQAP.
	I am aware of the issues to do with the scanning equipment at Sana’a airport. It is in place, but because of the security situation it has not been easy to get the people there to connect it and fix it up. That is a priority for us, however. As the situation eases, it will be an important thing for us to do.
	The right hon. Gentleman rightly paid tribute to my colleague, the Minister of State, Department for International Development, my right hon. Friend the Member for Rutland and Melton (Mr Duncan), who is doing an excellent job, such as in addressing humanitarian issues and in respect of the Friends of Yemen donor conference to come. He takes a particular interest in how the money is spent, and in reassuring those who
	have promised to be donors that the money will get where it needs to go. That addresses one reason why in the past donors have been hesitant to deliver on their commitments. So, I can assure the right hon. Gentleman that that is a matter of importance for us that we will continue to deliver on. We think there will be further meetings in New York later on in the summer, and possibly one in Riyadh. However, the Friends of Yemen have recognised the President’s abilities. He was not particularly well known before he took the position, but he is delivering in many different ways in Yemen. Although the security situation is difficult and will remain so, there are some good signs in a difficult area, and I hope to be able to report on those more often in the next 12 to 18 months.

DEPARTMENT FOR ENVIRONMENT, FOOD AND RURAL AFFAIRS

Glyn Davies: Thank you for calling me to speak, Mr Deputy Speaker, on a subject—the British dairy industry—hugely important to my constituency and, I contend, to our nation. I want to speak in particular about the crisis currently engulfing it.
	I have always appreciated the importance of dairying. My first job, for the first 10 years after I joined the family business, was milking cows. I do not suppose I am unique among Members in that regard, although I might be the only existing MP who has actually milked cows by hand. I often stayed with my grandparents when I was young; they had eight cows which they milked by hand, and they produced butter that was circulated in the village. Therefore, I feel a considerable attachment to the industry—and we really did use three-legged stools, for those who are wondering.
	Dairy farming has shaped and maintained the countryside of Britain as we know it for a century. It is an industry we should value and support. Today, dairy farming is in deep trouble—an important primary production industry torn apart by the corporate greed and ruthlessness of processors and retailers. Dairy farming is being reduced to an unsustainable position. Dairy farmers will be forced out of business and inevitably, more dairy products will be imported unless there is change. We should do our utmost to prevent this from happening.
	It is not possible to calculate precisely the cost of milk production because circumstances vary, but it is generally accepted to be 29p to 31p per litre. Some of our major retailers acknowledge this. Waitrose and Marks and Spencer contract with farmers and allow for the production costs to be covered. Sainsbury’s and Tesco, too, contract with farmers for some of their milk, and they too allow the costs to be covered. However, others do not and they should be named and publicly shamed: Asda, Morrisons, and Co-op are huge businesses that show a shocking disregard for their suppliers. The processors—the in-between businesses that buy from farmers and sell to the retailers—should also be named and shamed: Arla, Robert Wiseman and Dairy Crest are happy to watch suppliers go out of business, in order that they can maintain their large profits.
	The dairy products marketplace, as we know, is deregulated and unbalanced. The contracts under which milk is traded are incredibly one-sided. Buyers have discretion to impose price cuts almost without warning, while sellers are tied to long-term notice periods.

Andrew Stephenson: I congratulate my hon. Friend on raising what is a vital issue to the dairy industry. I recently met Roberta Parsons of Manor House farm in Brogden, in my constituency, which is a small farm with only 140 cows. Does he agree that it is the smallest farmers who are hardest hit by the reduction in milk prices and the abuse of power by the larger milk companies?

Glyn Davies: I thank my hon. Friend for that intervention. It is undoubtedly true that it is the average-sized businesses that are likely to survive and that can carry a period of loss, while the traditional farmers are likely to go out of business unless there is change.
	A few weeks ago, the processors reduced the price by 2p a litre—just like that: a 6% to 7% reduction. Now they have told farmers that on 1 August there will be another 6 or 7% cut, which reduces the price they are paying to the farmers to way below the cost of production. Last week, unsurprisingly, there was a huge reaction: 2,500 dairy farmers came to a dairy summit here in Westminster and many of my hon. Friends attended. The purpose was to highlight this unacceptable position, and to demand that these cuts do not ahead in August and that those that took place in July and July be reversed.

Andrew Griffiths: I thank my hon. Friend for raising this important issue, which is dear to both our hearts. Does he agree that this crisis enveloping the dairy industry, whereby on 1 August dairy farmers will face going bust, means that if we cannot find a voluntary code between the producers and the supermarkets, we should look to impose some sort of mandatory regulatory regime to save our dairy industry?

Glyn Davies: I thank my hon. Friend for his intervention, as he makes a point that I was intending to deal with. I was going to raise it with the Minister to seek his opinion and perhaps his assurance on that very matter.
	Processors in this deregulated, unbalanced market are behaving as though they are a cartel; they are imposing across-the-board cuts and there seems to be some agreement between them. That is outrageous behaviour. We know that across the world dairying is a volatile market—prices fluctuate. We all understand that; it is why there must be some order, which is why we have contracts. However, the current order is for the processors and the retailers, with catastrophic chaos for the producers. I shall now deal with the point that my hon. Friend raised. We need a code, preferably a voluntary one, and more balanced contracts. We had hoped that there would have been an announcement of a voluntary code already, and I know that the Minister had, too. Unless we can have an agreement on a voluntary code, the Government and the Minister have to consider going forward with a statutory code. Only with that hanging over people’s heads are we likely to achieve the voluntary code we want.
	In the longer term, the Government need to encourage progress on lots of other issues. We need to encourage farmers to come together to form producer organisations. The big problem we have with individual farm businesses and micro-businesses is that they are incredibly small and do not carry any power. We know that there is now an agreement from the European Union in the dairy package that we can encourage up to 30% of farm producers to deliver producer organisations. I am hoping that the Minister will reassure us that he wants to do that.
	We also need to move forward on the grocery adjudicator, although that might well have a limited impact on this particular problem, as for markets to operate we have to have a degree of fairness. When there is bullying and unfairness, the Government have to deal with it. That is why we have a Competition Commission, the Office of Fair Trading and other such organisations. The Government have to step in when the market is not working, and all of us know that this market is currently simply not
	working. It is working in favour of big bullying retailers and processors, and it is causing huge damage and driving into bankruptcy the dairy farmers that have sustained our countryside for so long.

David Hanson: I support the hon. Member for Montgomeryshire (Glyn Davies) in his request to the Minister today. The hon. Gentleman represents mid Wales and I represent north Wales, and a number of my constituents from the National Farmers Union and from the Farmers Union of Wales have echoed very much the concerns that he has raised. They simply cannot plan their businesses on the basis of a 2p cut in the price of milk already, with the potential for further cuts before 1 August. As he has mentioned, dairies such as Robert Wiseman Dairies are squeezing the dairy farmers of north Wales hard on the price of milk. A number of farmers in my constituency have raised the concern that they have potentially lost, because of the cut to their businesses, between £40,000 and £60,000 per business. No business could take a mid-year hit of that proportion with so little notice without it potentially having an impact on their viability. Farmers in my constituency came to London last week to raise the issue and are seeking the solution proposed by the hon. Member for Montgomeryshire.

Andrew Griffiths: I thank the right hon. Gentleman for giving way and agree with much of his speech. Does he share my concern that the contracts that dairy farmers have to put up with mean that they have to live with cuts of 2p, then another 2p, then further erosion, but if they want to get out of them they have to give six months’ notice? Does not agree that that is unacceptable?

David Hanson: I am grateful to the hon. Gentleman for raising that issue and the key is to have a code of conduct for the contracts. I know that the Minister had discussions last week about a potential voluntary code and look forward to his updating the House today on his progress. If a definitive decision has not yet been made, I would welcome hearing from the Minister what plans he has to ensure that during the period between now and when the House returns in September he will be able to update Members who have an interest in the dairy industry, as well as Members in general, on this matter. I share the wish of the hon. Member for Montgomeryshire to see a voluntary code at first, but I know that my colleagues on the Labour Front Bench would certainly support regulation through a statutory version of that code if the voluntary form was not successful.

Brian H Donohoe: I wonder whether my right hon. Friend can help me. Was it not a previous Conservative Government who did away with the milk marketing boards? The whole question of their being able to maintain prices meant that the farmers could maintain their businesses.

David Hanson: My hon. Friend and I have both been in the House since 1992 and I vividly remember the Mark Marque being abolished in the early 1990s, which led to a free-for-all that caused some difficulties. Let us put those issues to one side, however, as I am concerned about how we can make progress today.
	The Minister has an opportunity to explain to the House how he is progressing on the voluntary code. If a voluntary code does not succeed, he will certainly have my support and that of my hon. Friends on the Front Bench, I think, for a statutory code in due course. The key issue, however, is how to ensure that those who produce get a fair price for their produce. At the moment, the big businesses mentioned by the hon. Member for Montgomeryshire in his opening remarks, such as Robert Wiseman, can squeeze my constituents to the extent that they cannot make a living out of the production of milk.
	Much of the milk produced in my constituency does not go to retail in supermarkets, but into the production of butter, yoghurts, cheese and other produce. The code needs to encompass not just supermarkets but all outlets for milk.

Jim Shannon: Does the right hon. Gentleman feel the same concern as many of us about the large investments that farmers have had to make because of the new regulations on slurry and its disposal? That investment, on top of a worse price for milk, makes it more difficult for them to survive.

David Hanson: The key point is that whatever challenges farmers face in their investment and their businesses, no business can take the type of change that has been imposed now with a 2p cut some months ago followed by a further 2p cut by August. That is being imposed by businesses that are choosing to do so to enable supermarkets to have loss leaders. Customers can have cheaper milk, which must be welcomed in some ways, but ultimately we need a fair deal for all. We need a fair deal for producers, for supermarkets and for those people who buy and transport milk and make it into other products. At the moment, that is not happening because, as the hon. Member for Burton (Andrew Griffiths) said, the inflexibility of contracts means that farmers cannot get out of them.
	We need an update from the Minister on the review of the contracts and an examination of how we can ensure long-term stability for milk production. We need the voluntary examination of contracting and, if that fails, we need the Government to take regulatory action to ensure that the interests of all parties in this important industry, not just in my area of north Wales but throughout the United Kingdom, are defended.
	Finally, will the Minister update us on his discussions with my colleagues in the National Assembly for Wales? They have a devolved responsibility for some aspects of dairy production but contracting legislation must be dealt with on a UK-wide basis to ensure that markets are not further distorted between England, Wales, Scotland and Northern Ireland. I support what the hon. Member for Montgomeryshire wants to see, which the hon. Member for Brecon and Radnorshire (Roger Williams) will no doubt comment on in a moment.

Roger Williams: I, too, value the opportunity to bring the issue before the House. I attended the meeting of 3,500 farmers in the Methodist central hall. They were very angry and unhappy.
	The Minister handled the situation well, but it was a real demonstration of our dairy farmers’ frustration about their treatment.
	At a time when British agriculture is doing relatively well, milk prices have fallen dramatically. A year ago, the average price of milk was about 35p a litre; now, it is less than 25p a litre and, as we have been told, the cost of milk production for the average farmer is about 30p a litre. When people have to sell below the cost of production, we will undoubtedly see farmers leave the industry.
	In September 2002, there were 3,100 dairy farmers in Wales, but by May 2012 the number had fallen to 1,900. Across the whole of my constituency, there are fewer than 10 milk producers, which is a huge fall in numbers. There has been a downward trend in the production of milk. In 2003, 14.5 billion litres of milk were produced, but today the figure is around 13.5 billion. If those trends continue, the implications are bad not only for farmers but also for consumers. In the medium and long term, they are bad news for retailers and processors.
	What can be done to avert a crisis? There is no single bullet, but we need action at every stage of the supply chain, from farmers, processors, retailers, consumers and the Government. As has been said, farmers need to work together. The voice of one farmer carries little weight in the marketplace, but when they join together, their negotiating power is much stronger.
	Processors and retailers need to start paying a fair price for milk. Robert Wiseman Dairies, Arla Foods and Dairy Crest must scrap the scandalous price cuts they have imposed on farmers.
	Consumers can reward retailers that are doing the right thing. Sainsbury’s, Tesco, Waitrose and Marks and Spencer have a price formula based on cost. I commend them for that. Consumers should show their appreciation by voting with their feet, and indeed their purses, and punish the Co-op, Asda and Morrisons, which do not have a similar scheme.
	We need to start adding value to liquid milk. Our European friends are far better than we are at increasing profits from milk by processing it into cheese, yogurt and the like, which means it can be exported around the world.

Helen Goodman: I agree with the hon. Gentleman. In my County Durham constituency, many milk producers are suffering. I also agree that milk producers need to sell to wider markets, but does he agree that is no excuse for the behaviour of the wholesalers and the supermarkets?

Roger Williams: The hon. Lady makes a fair point. People who are powerful in the marketplace, such as the processors, use their muscle to bear down on the prices paid to producers, who are suffering.
	Finally, I turn to the Government. At the summit, the Minister said that a voluntary code between farmers and processors was close to agreement. Will he update the House on the latest progress?
	I commend the Government on the Groceries Code Adjudicator Bill, which is making its way through the other place. Let us ensure that the legislation passes quickly, with the teeth it needs to do its job.
	I welcome the work the Minister has already done on lightening the load of regulation on British farmers, but more can be done. I know he will continue to implement recommendations from the Macdonald report as and when he can.
	The dairy industry is in crisis, but the crisis can be averted. Let us work together, so that our dairy industry will have a brighter future.

Andrew Stephenson: I should like to raise the subject of dangerous dogs, as I was unable to participate in the recent Westminster Hall debate on the topic. Although I have publicly supported changing the dangerous dogs legislation for some time, and support the Government’s proposals, the issue took on personal significance for me in May. My mother, Ann, had her finger bitten by a dog while she was delivering local election leaflets in Colne. She was initially treated in Burnley general hospital and then transferred to a specialist unit in Wythenshawe hospital. I put on record my thanks, and my mother’s, to the doctors and nurses who treated her, and to the volunteers from Age UK who made her time in Burnley general more comfortable.
	The dog bit my mother’s finger so hard that it broke the bone, and it also bit off the nail and the end of the finger. She was kept in hospital for several days. It is worth noting that my mother is not alone: two local Liberal Democrat councillors in Pendle were also bitten in separate incidents in the same week. I have on a number of occasions been critical of the law relating to dangerous dogs, which fails to protect the public; indeed, in February, I wrote an article in the local press calling for changes to it.

Justin Tomlinson: This is a very important subject. Does my hon. Friend agree with my wife, who has studied animal behaviour, that the actions of a dog are almost always linked to the way the owner brings them up and handles them, and to where they purchase the dog from?

Andrew Stephenson: My hon. Friend makes an excellent point, and I know that he is acutely aware of the subject, given the recent high-profile case in his constituency, in which a two-year-old was attacked by a dog.
	Something must be done to protect postal workers, volunteers and the public from dangerous dogs, and to remind owners of their responsibilities. As we are all aware, postal workers are especially at risk; there are an estimated 6,000 dog attacks on them every year. Of course, the issue of irresponsible dog owners goes wider than that. Dog fouling, status dogs and noise nuisances are all raised with me and other hon. Members time and again. The local press regularly cover horrific incidents. Last October, I read about a Staffordshire bull terrier attacking a 10-year-old in Pendle after the dog had been given lager to drink. Of course, because of the way the current law works, no one was punished. Under the Government’s proposals, that would change, and I especially welcome the proposal to provide funds to train expert dog legislation officers in each force.
	There is widespread agreement that the Dangerous Dogs Act 1991 is one of the worst pieces of legislation in history. It is probably the best example of how knee-jerk reactions from politicians can sometimes make a bad situation worse. A key respect in which the legislation got it wrong was in focusing on breeds of dog, when the real problem, as my hon. Friend says, was and is irresponsible dog owners. However, surely one of the other biggest mistakes was that the law did not cover attacks that happen on private property. That is one of the most important issues for the Government to address, and the one that would have the biggest impact.
	To be clear, owning a dog is a great thing to do, and the vast majority of dog owners in Pendle and around the country are considerate and take responsibility for making sure that their dogs are safe. I congratulate the Government on engaging with the many groups that have come together to sort out the laws on dog ownership, many of which, including the Kennel Club and the Royal Society for the Prevention of Cruelty to Animals, e-mailed me before today’s debate. By getting the legislation right, we can make communities safer and more pleasant to live in, and protect the reputation of those dog owners who make sure that their pets are safe to the public.
	Thankfully, my mother is doing well, although the damage to her finger is permanent. She passes on her thanks to those colleagues of mine who have wished her well, but what she would value most is us at last introducing a law on dangerous dogs that works and protects the public.

Mark Williams: I return to an issue that colleagues raised a little earlier: the dairy sector, its critical importance to the economy, and the crisis that it faces. Last week, there was a gathering of 2,500 milk producers in central London; 300 of them were Welsh dairy farmers. There is understandably enormous strength of feeling on the part of the farming industry, following the latest round of cuts. We have heard from other hon. Members, and it is not an overstatement to say that the price cuts threaten the very future of many of the family farms that we represent, not just in Wales but across the United Kingdom as a whole. Indeed, the shortfall from that round of cuts will cost the Welsh dairy industry alone an estimated £80 million per annum—a huge sum of money that will put many dairy farmers out of business. The right hon. Member for Delyn (Mr Hanson) discussed the hit that businesses would suffer—£40,000, £50,000, or £60,000—and that would drive many struggling family farms out of business.
	Although the price cuts have been set by milk processing companies, there are things that Government can do to assist our dairy farmers. The Government have commendably introduced the Groceries Code Adjudicator Bill, which is going through the other place, and I share the farming industry’s eagerness to put that law in place as quickly as possible. I am relieved that, after so long, legislation is coming our way, as it will restore some confidence in the industry and enable consumers to make real choices between the practices of different supermarkets, allowing them to choose which ones they shop from. It will provide, I hope, an adjudicator with real teeth, but it will not guarantee farm incomes.

Neil Parish: Asda has said today that it will put its prices up by 3p for direct sales for farmers, but in 2010, it dropped the price of milk for four pints from £1.50 to £1. Does my hon. Friend agree that that brought about the drop in milk prices across the piece?

Mark Williams: My hon. Friend graphically illustrates the inconsistent role of some supermarkets. Along with the groceries code adjudicator, we need to look at how we can bring about fair contracts, to which everyone who has spoken has alluded, to stop the exploitation—an emotive word, yes, but that is the perception on the farms that I represent, as well as that of the National Farmers Union and the Farmers Union of Wales. The contracts that farmers are required to enter are simply unfair, as they are required to give 12 months’ notice or more to pull out of them whereas, as we have heard, processors can change the price they pay for milk at a few days’ notice, or quite literally overnight.
	The Government are right to move towards a voluntary code. Like other Members, I look forward to an update from the Minister but I hope that if necessary, the Government will proceed with regulation. As Lord Plumb said in another place, rule books without referees generally have limitations. We all agree in the House that farmers deserve to receive the production cost for their milk, but Robert Wiseman Dairies has announced that from 1 August it will pay 24.73p per litre for milk. Arla Foods milk price will fall to 25p a litre, and the First Milk price to 24.35p a litre—5p less than the cost of production. Any situation in which farmers have to accept less than the cost of production is unsustainable. I commend Waitrose, Sainsbury’s, Tesco, and Marks and Spencer on the positive work that they have undertaken, but we need to ensure that those agreements are made across the board, from retailers to processors, with all major buyers of milk and dairy products agreeing to commit to a sustainable purchasing strategy.

Helen Goodman: Does the hon. Gentleman not agree that there is a problem with milk imports from countries with lower animal welfare standards and costs, and that those imports are not labelled in the UK?

Mark Williams: The hon. Lady served in the previous Parliament when, to be fair, the issue of labelling rose to prominence. It is critical, because it enables consumers to make informed decisions.
	Given the feelings in the farming community about the recent price cuts, compounded by difficult weather conditions and rising input costs on-farm, the Government need to make it clear to processors and supermarkets that their failure to deliver fair prices may lead to severe disruption to the supply chain with dire implications not just to farmers but ultimately to us as consumers.
	It is always worth remembering that the losses in the dairy sector will have a huge—I do not use that word lightly—impact on the broader rural economy. Welsh Assembly Government statistics indicate that, as my hon. Friend the Member for Brecon and Radnorshire (Roger Williams) said, the number of dairy farms has reduced by 800 over the five years from 2006 to 2011. The number of dairy farmers in Wales alone halved in the past 13 years. This figure will rise if we do not take
	action over the current price slash and unfair contractual obligations, because they will mean many job losses across the industry among suppliers.
	Next week the Welsh farming community, in its widest sense, will gather for the Royal Welsh show in Builth Wells in the constituency of my hon. Friend the Member for Brecon and Radnorshire (Roger Williams). We will see there the breadth of the farming community. The supermarkets, the farming unions and the Young Farmers will be there, as will the machinery contractors, the feedstuff merchants and the farming families from Wales and beyond. I make this prediction: whatever the weather, the sheer number of people there will illustrate how important the industry is to rural Wales. The stakes are high.
	It is election time in Ceredigion, when we have hustings with the farming unions—the FUW and the NFU. Before elections, I am always asked this question: “Would you encourage a young farmer, the son of a farming family, to go into the industry and continue with the family farm to earn a living and contribute to the broader rural community?” With hand on heart, if things do not improve and we do not have action, I would hesitate about whether I could say yes to that question.

James Paice: I was expecting at least one further subject to be brought up during the debate. [ Interruption. ] That, like many other wonderful speeches, will be consigned to the filing cabinet of those never to be delivered in this Chamber.
	I hope that the House will forgive me if I devote most of my response to dairying, which was the subject of most Members’ speeches. First, though, I will reply to my hon. Friend the Member for Pendle (Andrew Stephenson). I am very sorry to hear about the dog attack on his mother. I am pleased to hear that she is recovering, even if she will bear the scars for the rest of her life. He was absolutely right to refer not only to the measures that we have announced but to the importance of dealing with dog owners. As he said, often the problems with dogs are in fact a problem with the owner, either because they do not understand how to control the dog or have the desire to use it as a form of weapon for intimidation or worse. That is why the Home Office proposals on antisocial behaviour will include measures on the use of a dog as a weapon, which will rightly be see as an antisocial activity and dealt with in that way.
	My hon. Friend referred to the measures that I announced on 23 April. The consultation that stemmed from that closed on 15 June. We have begun to analyse the responses and will announce our conclusions as soon as we can. To recap, the most important element was to extend the criminal offence of allowing a dog to be dangerously out of control on private property, which addresses his point about postmen and the many other people who have a legitimate right to come on to one’s property. We are consulting on the compulsory microchipping of dogs—in particular, precisely on how early to do that and whether it should be at the puppy stage. We are increasing the fee for placing a dog on the index of exempted dogs. We are removing the need to seize and kennel all dogs where court proceedings are
	pending. We are also, as my hon. Friend said, making a grant to the Association of Chief Police Officers for the training of dog legislation officers. I hope that he agrees that we are endeavouring to address an issue that is long overdue.
	Dairying and the crisis in the British dairy sector were referred to by at least four Members in their speeches and by others in interventions. Like my hon. Friend the Member for Montgomeryshire (Glyn Davies), I had milk cows earlier in my life. I fully recognise the huge crisis that is affecting many people in the sector. As a number of Members have said, some supermarkets that have aligned groups of producers have not cut their prices. However, the processors for many producers cut their prices in May or June and have announced further cuts for 1 August. The cut will total some 3.5p to 4p per litre over the two periods. We now seem to have an industry of haves and have-nots—those who have a supermarket deal and those who do not.
	As my hon. Friend the Member for Tiverton and Honiton (Neil Parish) said, there has been some good news today. Asda has announced that it will increase the premium that it pays its processor, Arla Foods, by 2p a litre, thereby nullifying the cut that Arla has announced. In other words, the producers affected will not face a cut on 1 August. From memory, that is about 227 producers. Dairy Crest has announced today that, in future, it will require only three months’ notice when producers leave their contracts, and it has guaranteed that it will give four weeks’ notice of any price cut.

Bob Stewart: I have been listening to the debate and, although I do not know much about this subject, it seems to me that we should somehow ensure that price cuts are not passed on to the dairy farmer. The big supermarkets should take whatever they wish, but they should not pass it on to the milk farmers.

James Paice: My hon. Friend’s point is properly made and is an important one.
	I will concentrate on the issues that need to be addressed. I fully recognise that what matters to the dairy farmer is the price that they are paid. However, as several hon. Members on both sides of the Chamber have said, it is not simply a matter of reversing the price cuts, although that is what the producers want. We need something more substantial and more permanent than that.
	As I say frequently outside this place, we have an obsession in this country with the liquid market and with the desire of our processors to gain bottling contracts for supermarkets. They keep undercutting each other to keep their bottling plants at full capacity. When, as has happened on this occasion, cream prices collapse and they face major problems, the only way in which they can recoup any income is by cutting the price for their producers to below the cost of production. That is a direct consequence of the obsession with bottling for supermarkets.
	As several hon. Members have said, and as is abundantly clear, there are ample other opportunities for investment. Some 20% of our total dairy consumption is imported. The hon. Member for Bishop Auckland (Helen Goodman)
	talked about imports. We do not import liquid milk. All the imports are dairy products, but they nevertheless make up a significant part of our total consumption.
	What are our processors doing to combat that? One or two are trying to do something. Dairy Crest has gained back some of the cheese market with one of its products and it should be congratulated on that, but there is still much to do. Where do the supermarkets with aligned dairy groups, which pay a premium for their liquid milk, get their own-label brands? Where are their other dairy products, such as their yoghurt, produced? Do they use British milk? In many cases, they do not. There is therefore a great opportunity for import substitution.
	There is an even greater opportunity for exports. The world is crying out for increased dairy products. Yes, global prices have fallen back and that is part of the immediate problem that we face. However, I say to my hon. Friend the Member for Ceredigion (Mr Williams) that if I was asked whether I would encourage a young person to go into dairy farming, my unequivocal answer would be yes, because I am convinced that there is a long-term future beyond today’s crisis.

Anne McIntosh: Will my right hon. Friend give way?

James Paice: No, I am sorry, I need to press on.
	Hon. Members also raised the issue of supermarket power. As has been said, we are introducing the groceries code adjudicator. I have always tried to be honest with farmers and say that on its own it will not increase the price of milk, but that it should increase fairness and transparency.
	The big problem that we face, which has been mentioned this afternoon, is what I view as the absurd level of price cutting by some retailers, particularly those in what is known as the middle ground. One retailer is openly selling milk at 99p for four pints.

Helen Goodman: Name them.

Brian H Donohoe: Iceland.

James Paice: It is on the record, and I did not move my lips.
	The reality is that such a price is completely unsustainable. Such retailers need to understand that if they go on like that, there will be no milk. There is a limit to cost cutting. Maybe some producers can cut their costs, but not to that level. It is completely impossible. There is no country in the world that can sell bottled milk at the equivalent of 25p a pint by the time it has been through the whole processing chain. That is absurd, and such retailers are biting off their nose to spite their face.
	The final issue that several hon. Members raised was the lack of producer power and the need to promote producer organisations. That brings me to the dairy package and the voluntary code. I am grateful to Members of all parties for the support that they have expressed this afternoon for my work in trying to get a voluntary code. I genuinely believe that that offers a far better prospect than legislation, and I shall explain why.
	A voluntary code can, if agreed by both sides—the processors and the producers—cover such issues as price, notice periods, contract lengths, volume and exclusivity. A raft of other points could be included if both sides wanted them to be. Conversely, the dairy package and the legislation that would be permissible under it are about a contract, not a code. We could legislate to make contracts compulsory, but the permitted legislation would limit greatly what could be put into those contracts.
	For example, as we understand it, no notice period would be permitted. A length of contract would be specified, and it would probably be a year or more. The idea of a short notice period to get out of a contract would not exist. That is just one of many examples showing that the regulatory route, which I fully accept appeals to some people, is not as good as a code, which could accommodate a range of measures.
	I agree with farmers and others who said last week that we cannot go on like this, because the discussions on a code have now taken 14 months and we cannot continue simply hoping it will happen. I had a meeting with both sides last week before the public meeting to which reference has been made. We got very close to an agreement, but both sides still had what I considered to be very minor issues to resolve. Those issues were obviously important to them, and they were not resolved. There have been further, private discussions with my officials and others over the past few days, and I intend to precipitate a final decision. I do not want to give the House more information than I have given the industry, because that would not be right, but I intend to say that enough is enough, that the negotiations have been going on long enough and that it is time for both sides of the industry to show some maturity and demonstrate that they can agree a voluntary code of practice.
	I would be foolish to pretend that it is a certainty that we will get a code. There are still some stumbling blocks on both sides, coming both from those representing producers and from at least one major processor. However, I have every intention of driving the process forward and getting a result. We have got to the point at which knowing it was not going to happen would be better than living in the never-never land that we have been in for some time. However, I emphasise that I do not believe that the regulatory approach recommended by some hon. Members would give either side of the industry anything like the beneficial future that is there for the taking.
	I hope I have answered the points raised by hon. Members in the debate. I entirely share their concerns. I can assure the right hon. Member for Delyn (Mr Hanson) that we are in discussions with colleagues in the devolved Administrations. We are getting together prior to the Royal Welsh show this weekend. We were going to discuss the common agricultural policy, but we will also discuss the situation in the dairy sector. I can only hope that, before the cuts take place on 1 August, we can get a voluntary code at least. I hope others agree that that is the best way forward.

GENERAL MATTERS

Lindsay Hoyle: We now come to the debate on general matters. I will start off with a six-minute limit on speeches, but if there are too many interventions, I will have to drop the time. I am trying to get everybody six minutes. I am sure it will be a good debate as we go into recess.

Barbara Keeley: There is a strong and growing sense of anger in Salford and across Greater Manchester about the Government’s decision to axe to 2nd Battalion the Royal Regiment of Fusiliers. A strong campaign in the Manchester Evening News is asking the Government to rethink their plans.
	The 2nd Battalion has a long and distinguished service history dating back to the Lancashire Fusiliers. Nineteen heroes from the Lancashire Fusiliers, which became the 2nd Battalion, were awarded the Victoria Cross for bravery. The battalion has served this country in every major conflict since 1674. Many of its soldiers gave their lives fighting for this country.
	In 2009, the 2nd Battalion of Fusiliers completed a tour of Afghanistan in which it lost seven men killed in action. Others were wounded, some very seriously. Three of the seven died together in an explosion while on patrol near Sangin in Helmand province on 16 August 2009, including Fusilier Simon Annis from Salford. Simon and fellow Fusilier Louis Carter were trying to drag their injured comrade, Lance Corporal James Fullarton, to safety after a roadside bomb blast, but as the pair lifted Lance Corporal Fullarton on to a stretcher, they triggered a second device, causing an explosion that killed all three soldiers, who died at the scene. Simon was on his first operational tour. He was described by a senior Army officer as a “shining example” to the nation. Simon Annis had been married for just a month before he deployed to Afghanistan.
	When the 2nd Battalion had its homecoming parade from Afghanistan later in 2009, Salford people lined the streets to give the returning soldiers a warm welcome. I was proud to be at the parade and to meet my constituents, Ann and Peter Annis, the parents of Fusilier Simon Annis. The pride his parents feel is replaced by anger at the Government’s decision to axe the battalion their son served so valiantly. Simon’s mother Ann has said:
	“Simon was so proud to serve in the battalion and now this feels like a smack in the face. He died with his mates in that battalion and now it will be gone…Lads are still in Afghanistan and dying out in Afghanistan and the Army are talking about cuts and job losses. Morale must be at rock bottom.”

Bob Stewart: My uncle served in the Lancashire Fusiliers and I am very proud of that fact. Does the hon. Lady agree that it would be a good idea if the Government could rethink their policy on cuts to infantry battalions—the three in England, one in Wales and one in Scotland—at least until we are out of Afghanistan?

Barbara Keeley: I very much agree with hon. Gentleman. I am today asking for such a rethink.
	The decision to axe the battalion feels like a betrayal to the memory of Simon Annis and the other soldiers who have given their lives. I agree with Mrs Annis that
	the decision is bad for morale—it must be. There is a deep attachment in Salford and across Greater Manchester to this battalion, the Lancashire Fusiliers, which has such a long and proud history of service to this country, as I have mentioned. The 2nd Battalion is linked to Salford and other places in Greater Manchester. At this difficult time for employment, its loss will significantly reduce the opportunities for local people who want to enter a career serving their country. Furthermore, the decision will put 600 soldiers and officers at risk of being made redundant.
	Brigadier David Paterson, the honorary colonel of the 2nd Battalion, wrote in a letter to General Sir Peter Wall that the decision would not best serve the armed forces. In the letter, he tells of his bitter disappointment at the decision to cut the battalion, which he describes as
	“the strongest in raw manning and deployable strength”,
	and he writes of the difficulty he will have in telling his fusiliers, in an almost fully staffed battalion, why they are now likely to be posted to battalions that cannot recruit as well as the 2nd battalion, which has 523 trained soldiers out of a maximum strength of 532. He has questioned the criteria being used to single out the unit, which actually has a strong record in recruiting new soldiers and is the only regiment set to grow over the next six months.
	The Secretary of State said yesterday that the recruiting ability of regiments over a period of 10 years had been taken into account when deciding these cuts, but it seems wrong, given the different employment situation today and the battalion’s strong record in recruiting, to take what must have been a few leaner years of recruitment as the reason for axing this historic battalion. I urge Ministers to reconsider the decision and instead respect the proud history and valour of the 2nd Battalion, of which I and the people of Salford are so proud.

Andrew Turner: A good education is the best start that a child can be given, so I am pleased that the Isle of Wight further education college provides a great education and now has the added benefit of a sixth-form department. Before the current principal, Debbie Lavin, took over, results were poor, but under her leadership it has become a flagship college. I am also confident that Christ the King sixth form, which will open in September, will be of a high standard and give its students a similar excellent start in life. I wish the principal, Pat Goodhead, the chairman of governors, David Lisseter, and all those involved with Christ the King college well in their endeavours.
	Unemployment on the Isle of Wight has fallen in recent months, which is welcome news, but the news is not so good for young people. I know that Ministers are working hard to reduce youth unemployment, but one way of doing that is to increase the number of apprenticeships. To that end, the Minister for Further Education, Skills and Lifelong Learning, my hon. Friend the Member for South Holland and The Deepings (Mr Hayes), has agreed to visit the island in December to help us boost local apprenticeships.

Brian H Donohoe: Apprenticeships are dear to my heart, but not enough is being done. Is the college that the hon. Gentleman mentioned going to increase the number of apprenticeships it provides?

Andrew Turner: It is necessary that apprenticeships be expanded at all levels, which is why I am glad that my hon. Friend the Minister is visiting. I look forward to it.
	One positive way of gaining experience while looking for employment is voluntary work, and there are many excellent causes on the island. For example, the Isle of Wight food bank, which has been doing a sterling job since its launch a year ago, has helped more than 2,000 people in dire straits by providing food donated by other islanders. I pay tribute to Hannah King, who runs the food bank, and all her volunteers for the sterling work they do.
	Finally, I want to touch on events that brought parts of the island to a standstill for more than 24 hours last month. Many hon. Members will have seen the headlines about the Isle of Wight festival chaos. The festival has been held in its present location since 2002, but owing to atrocious weather and a clear lack of contingency planning, some island roads were gridlocked on 28 and 29 June. The impact on some islanders’ lives was very serious. Vehicles were at a standstill for hours, blocking roads and preventing islanders from getting to work, school, hospital appointments and the ferry terminals, while ferries sat in the Solent for up to five hours, unable to unload cars; there was nowhere for them to go. School children missed important exams, and others walked home when there were no buses. Some families were unable to get to the funerals of relatives, and other funerals were cancelled.
	It is not for me to apportion blame, but a bad situation was certainly made much worse by a lack of communication with the island’s media. For example, Michael Coombes and Paul Topping, along with Heather McCallum, Glyn Taylor and Lucy Morgan of Isle of Wight Radio, worked tirelessly to try to keep islanders abreast of events. However, their efforts were largely thwarted, because nobody would tell them what was going on. Thankfully, the situation was finally brought under control on the Friday morning, when alternative car parks were opened. Many islanders showed amazing community spirit, offering food, shelter and other help to stranded festival goers. That included the Vectis 4x4 responders. Without their help, vehicles would have been stuck in the mud bath that was the festival car park for many more hours.
	In order to ensure that such problems do not arise again, we need to know what went wrong this year. The organisers, Solo, are not covering themselves in glory. First it was announced that refunds would be given; then Solo said that they would not. I know that VentnorBlog has asked Solo a number of times for a copy of the emergency safety plan, but those requests have been ignored. Solo may not feel accountable to local people or our local media, but without local good will the festival will be harder to stage. I want the festival to continue—so do many others on the island and, of course, off it—but Solo must ensure that local people are able to go about their lives around it. Then we will all benefit again.

Roberta Blackman-Woods: I want to use this afternoon’s debate to put down a marker of my concern about the changes in Government policy towards further education and the introduction of further education loans, and also about the possible impact of changes to higher education funding on social mobility. I am particularly concerned that the introduction of further education loans will discourage people from disadvantaged backgrounds from taking up access courses to university or, if they are over 24, from entering FE to undertake level 3 study.
	A couple of years ago I visited a school in my constituency which some years previously had had poor attainment levels. Because of the investment by the last Labour Government, it had massively increased its levels of success at GCSE and A-level; hence, for the first time ever, a lot of the young people there were considering going to university. However, I had a conversation a couple of weeks ago with a group of young people from the same school who were just not so sure that going to university was a possible way forward for them. That should be a matter of great concern to this House.
	Last month I attended, as I do every year, the New College Durham graduation ceremony in my constituency. The students at New College range from 16-year-old school leavers to adults with families who have gone back into education, often after losing their jobs. I congratulated them on doing the right thing—on getting a good education and working hard—and I wished them all the best for the future. However, I am concerned that introducing further education loans may reduce the number of such people in colleges across the country who are getting the education they deserve, gaining the skills for a new career or accessing higher education. In 2010-11, more than 370,000 people aged over 24 were studying at this level, so the change will not affect just a small number. The people in FE want to reskill, but they also want to get promotion or enter employment for the first time. We are risking our economy and our future economic growth by not encouraging that group of people to reskill.

Brian H Donohoe: Does my hon. Friend agree that much more emphasis should be placed on apprenticeships, which I mentioned earlier in the debate, by the colleges themselves?

Roberta Blackman-Woods: My hon. Friend makes a useful point. We need apprenticeships, but it is important that people—especially those aged over 24—are able to take up those apprenticeships. We also need to support the 16 to 24-year-olds in apprenticeships, as that is yet another route by which they can gain skills and get into the labour market.
	Projections predict that, by 2020, 56% of jobs will need to be graduate level jobs in order to meet the demands of a knowledge-based economy. It is vital that people from all backgrounds are able to get the necessary education to get those graduate level jobs. The Liberal Democrat peer Baroness Sharp of Guildford has recognised that the introduction of further education loans threatens social mobility, saying that she cannot understand why the Government are pushing forward with loans for
	level 3 study while they claim to be concerned about social mobility. I ask the Minister to comment on that point today.
	In my constituency in Durham, there has been a 355% increase between May 2011 and May 2012 in the number of people who have been claiming jobseeker’s allowance for 12 months. If those people want to get an education, start a new career and get out of the trap of unemployment, we need to ensure that they have access to the necessary education. A survey conducted by the Department for Business, Innovation and Skills has found that the proportion of people surveyed who were willing to take out a loan for further education has dropped dramatically for higher age cohorts. Worryingly, that suggests that the policy could do real damage to the lifelong learning sector and to the ability of people to retrain and re-skill in their 40s and 50s, which could block their chances of regaining employment.
	The importance of further education can really be seen at the moment, with so many people unemployed right across the country, but even in the good times we need people to be able to gain skills in certain industries to maintain our global competitiveness. In 2006, the Leitch report called for the continued up-skilling of Britain’s population, but the Government are failing to implement those proposals.
	I also want to consider what is happening in the higher education sector. About 70% of those enrolling in higher education access courses are women. I know from a recent letter from the Minister for Further Education, Skills and Lifelong Learning that people who undertake access courses and get into university will have the money that they spend on those courses refunded, but we must also take into account the deterrent effect that having to take out a loan could have on people enrolling in access courses in the first place. I am also worried that the number of applications to universities for courses starting in 2012 has reduced dramatically. That might not follow through to a reduction in the number of students going to university, but we should be worried by the fall in applications.
	Finally, I want to make a plea to the Government to keep supporting the widening of access to our universities. We know that they have allocated £140 million this year for widening participation, but it is essential that those funds should be not only maintained but increased so that education can fulfil its role as a route to social mobility.

Bob Blackman: It is a pleasure to follow my near namesake, the hon. Member for City of Durham (Roberta Blackman-Woods). I want to talk about three issues: the general position of policing and criminal activity in London; the excellent work being done by Harrow police; and the scandalous proposal to close the custody suite in Harrow.
	On the general position in London, some 300,000 people were arrested last year for alleged crimes, of whom 100,000 were foreign nationals. Of the 100,000 foreign nationals arrested, 86,000 were convicted of a criminal offence. I am one of those who welcomes tourists who come to this country on holiday, spend their money here and enjoy our wonderful heritage. I also welcome those who come here as students and who
	learn about this country and go back to their own countries enriched by their experience of the United Kingdom. I welcome those who come here to work and pay their taxes, and the families that choose to live here and integrate into society, becoming part of our great British society overall. However, those who come as guests and then commit criminal offences, and who are responsible for a third of London’s crime, are a danger to everyone else who comes here to make this country their home.
	That is a key concern. The worst aspect is that, as I understand it, of those 86,000 people convicted of criminal offences, none were deported. Worse still, none were barred from returning to the UK if they chose to leave of their own volition. That, of course, creates community tensions and concerns for all the law-abiding people who have come here either to live here or on a visit. This requires prompt and immediate Government action.
	Let me turn to the issues in Harrow. I recently had the pleasure and honour to attend a commendation service for 22 policemen and women who were commended by the borough commander for courage and for work above and beyond the call of duty. These brave individuals do an excellent job in ensuring that Harrow is London’s second safest borough. They cannot be praised highly enough. I believe it is right and proper to pay tribute to all those brave men and women who lay their lives on the line almost daily so that we can go about our business in a carefree manner, as we would all wish.
	Finally, the third issue I want to deal with is the scandalous proposal to close the custody suite in Harrow police station. Everyone knows that when people are arrested, they are often violent, they are sometimes intoxicated and they can give the police a very hard time. Such people need to be transported to a custody suite, and processed and looked after in the prison cells, if required, in the most expeditious manner possible. The last thing that is needed is to transport people arrested in Harrow to Wembley or even to Kilburn when they may be violent, intoxicated on drink or drugs and causing many problems for police officers.
	Another key concern is that if this proposal were to go ahead, police officers would be dragged away from Harrow to go to Wembley, Kilburn or beyond to process these individuals, and criminal investigation department officers would have to attend at one of those police stations to interview them and make sure that they were safe and secure overnight, if necessary. That, to me, is dragging away police officers who should be patrolling Harrow streets and unnecessarily tying them up in work that they should not need to do. Equally, there is a concern that people who have been arrested and put in police cells need to be inspected by police inspectors on a regular basis to make sure that they are safe and secure, and thus in a position to be interviewed. What is being proposed suggests that there will be an attempt to move the CID officers from Harrow to Wembley or Kilburn in order to facilitate all this investigation work and the necessary work of policing.
	I therefore ask responsible Ministers to step in and make sure that this proposal bites the dust very quickly so that we do not see a drag-down of police officers and
	a drag on police time and resources in Harrow, and so that we do not cease to be London’s second safest borough.

Bob Stewart: Briefly, was this a police decision or a decision by someone else?

Bob Blackman: It is currently a proposal across London to close certain custody suites. I am obviously concentrating on my own constituency, but my hon. Friend should be clear that a similar proposal might well come forward for his own constituency, which will impact on his own borough of Bromley. We have to be careful about this across London.
	I am particularly concerned because I know that when people are arrested in Harrow, at certain times of day it can take almost an hour to get to Wembley or Kilburn police station. Members can imagine a scenario involving violent criminals kicking off in the back of a police van that is dragging policemen or policewomen to another station where they will be tied up for several hours. Resources in Harrow will be severely stretched, and I suspect that there will be proposals for other custody suites to be closed throughout London, which I think would be wrong. We need to make it clear that custody suites should be in the most locally appropriate area, so that criminals can be processed in a humane and orderly fashion rather than transported for huge distances, tying up police resources unnecessarily.
	I am sure that a Minister will respond to me in writing, but I hope that the Deputy Leader of the House will take the issue on board as well, so that we can be given an answer. I know that all three Harrow Members are very concerned about this, as are the Harrow public.

Jonathan Lord: Will my hon. Friend give way?

Lindsay Hoyle: It is too late.

Nigel Dodds: I thank you, Mr Deputy Speaker, for giving me the opportunity to participate in the debate.
	The Northern Ireland Executive have designated 2012 the “our time, our place” year, because of the number of significant anniversaries and major events taking place in the Province. Given that we are nearly halfway through 2012, I think it would be useful to take stock of what has happened in Northern Ireland so far this year,
	We have had some enormous successes. The Irish open golf championship was the first European tour event ever to sell out completely—in this instance, for all four days of the competition. It was a fantastic occasion, despite the weather, which did its best to dampen spirits. We have also experienced the build-up to the Olympics. I am pleased that Northern Ireland is providing training venues for the Chinese male and female gymnastics teams and the Cuban boxers, among others. A few years ago it would have been unthinkable for those teams to stay in Northern Ireland to train, so that is a sign of the great progress the Province has made.
	This year was also the centenary of the sinking of the Titanic, which was marked by the opening of the iconic Titanic Experience building in Belfast, which is already attracting visitors whose number massively exceeds that predicted. The great news is that two thirds of the visitors are “out of state”—an encouraging sign for the sustainability of this major new tourist project. Belfast has again stamped its mark on the Titanic name, which is important given the association of that great ship with the city where it was built.
	Her Majesty’s visit to Northern Ireland on 26 and 27 June was an enormous success. A great deal of attention was paid to the famous handshake between the Deputy First Minister and Her Majesty. I for one was delighted that Her Majesty was able to come to Northern Ireland, which is part of the United Kingdom, and that the Deputy First Minister was presented to her as part of the jubilee tour. That too is a sign of the enormous progress we have made. Her Majesty has been to Northern Ireland 20 times during her reign, but the fact that on this occasion she was able to proceed through part of Belfast in an open-top vehicle in the presence of 20,000 members of the public shows just how far the Province has come.
	Later this year, we shall mark the centenary of the signing of the Ulster covenant on 28 September. Back in 1912, 500,000 people signed the covenant enabling Ulster to remain part of the United Kingdom, in opposition to the third Home Rule Bill. It is often forgotten that, two years later, more than 2 million people in Britain signed a similar covenant. We look forward to those events later in the year.
	Next year, we shall celebrate Londonderry’s becoming the UK City of Culture, and the world police and fire games will come to Belfast. We have very good things to look forward to as we continue to make progress with the political stability that now exists at Stormont. However, we must also confront challenges and difficulties, one of which is facing up to the events of the past. This Saturday, 21 July, marks the 40th anniversary of the Bloody Friday bombings in Belfast. We have heard a lot this year about the Bloody Sunday 40th anniversary, but it is often forgotten that just a few months later some of the worst atrocities ever carried out by the IRA took place, when 22 bombs were set off in Belfast city centre in an 18-minute period, killing nine people and injuring 130, including 77 women and children. Many of those victims and their families still bear the mental and physical scars to this day. We must never forget to honour the memory of those victims, and, indeed, all the victims in Northern Ireland. Justice demands that those who know about what happened in those events—we know, for instance, that Gerry Adams was commanding officer of the IRA in Belfast at that time—should come forward even now and tell the victims and society at large what they know, in order to provide closure and truth for the victims.
	In recent days, the Orangefest took place on and around 12 July. There were many Orange parades throughout the Province. Almost all of them passed off entirely peacefully, but there was orchestrated violence aimed at the police—include gunshots—by republican dissidents in Ardoyne in my constituency. Some people simply do not want peace; they do not want a resolution to any of the problems we face. There have been attacks on Orange halls at Greencastle and Clifton street in my
	constituency and at Glenavy in County Antrim. The fact is, however, that the people of Northern Ireland want to move forward. They do not want to be held back by this tiny minority of dissidents who are opposed to the peace process and political stability.

Jim Shannon: On the violence in north Belfast, does my right hon. Friend agree that the Parades Commission has a job to do, which it has not yet done?

Nigel Dodds: Yes, and I will come on to that point soon.
	In the months and weeks leading up to this year’s parading season, community representatives, clergy and political leaders did a lot of hard work on the ground on many different topics. There were talks, supported and encouraged by local politicians, on parades and protests involving the North and West Belfast Parades Forum and the Crumlin and Ardoyne Residents Association. The Democratic Unionist party, Sinn Fein and others in north Belfast sat down and worked on investment and regeneration plans, and sought resolution to long-standing issues. By making progress across a range of issues, we can create the environment for the resolution of the most difficult problems. I am determined that that should continue.
	My hon. Friend the Member for Strangford (Jim Shannon) just referred to the recent situation having been made worse by the gross mistakes of the Parades Commission. That was the case.

William McCrea: This point applies not only to north Belfast, but to my constituency of South Antrim, where, once again, the Parades Commission bungled things—but, thankfully, sense prevailed and the Orangemen and women did their best to ensure a very happy day for all.

Nigel Dodds: I am glad there was such a happy outcome in my hon. Friend’s constituency, and he is right to pay tribute to the people on all sides who worked to bring that about.
	There has been a notable lack of support, or even understanding, in both communities in Northern Ireland for the Parade Commission’s mad and bad decision to give a boost to a dissident republican mob intent on violence in the Ardoyne area of my constituency. The chairman is now trying to divert blame by passing the buck to others, which only serves to illustrate how out of touch he and his colleagues are.
	We will remain committed to working through these problems. They are isolated and small in number, but they cause great difficulties for my constituents on both sides of the community. The Secretary of State for Northern Ireland and the Government must recognise that the tremendous progress that has been made in Northern Ireland must not give a veto, or allow dissidents who are against everybody who is for peace and political progress in Northern Ireland to hold the rest of society to ransom.

Justin Tomlinson: As the Minister with responsibility for culture, communications and creative industries, my hon. Friend the Member for Wantage (Mr Vaizey) is set to review the future provision
	of e-books in libraries, now is a very apt time to highlight the options, challenges and opportunities of e-book lending for libraries, and by default for the publishers and the authors, who control the rights to e-books, focusing in particular on how we can make e-book provision widely available in a manner that supports and sustains our excellent community library network and credits the creative industries.
	My research has brought to light some interesting statistics. E-book sales in 2011 were up a staggering 366%, making up some 8% of the market and worth £92 million. Physical book sales in the first half of 2011 fell to a 10-year low, and e-book production overtook hardback output for the first time ever. In researching this issue and preparing this speech, I have been very grateful for the feedback from and views of various library campaign groups, experts, publishers, booksellers and professional librarians. I can tell the House that not everybody agreed with my initial thoughts, which I am about to set out, but it is important that we put those on the table as part of this review and try to make some progress.
	My view is that, in principle, e-books should be widely available throughout the library network. Currently, 94 local authorities offer some form of e-book provision, but the available stock is at best poor, predominantly because the big six publishers are not willing to release their stock. They will not do so, first, because the private label rights arrangement whereby publishers and authors get 6p every time a physical book is lent out does not apply to e-books. In the business world, authors and publishers need some form of incentive. There is also a worry that the balance between physical sales and library usage would be altered, resulting in fewer physical sales.
	At the moment, the balance between paperback and hardback book sales, and library usage, works. It is often more convenient physically to buy a book than to borrow one from a library: for example, some supermarkets that offer books open 24 hours a day, whereas libraries have limited opening times. Some people choose not to use a library because they do not like the idea of a second-hand book that somebody may have spilt their tea and biscuits on. A significant number of people who purchase books do so to display them on their shelves. I do not envisage people being told on visiting someone’s house in the future, “Please browse my hard drive to look at what I have been purchasing.”
	It is therefore clear that for publishers to release their e-books, they will have to be paid for, and there are two options. First, a Government—of whichever colour—will have to write a very large cheque, probably considerably bigger than the one they already write for the PLR arrangement, to release those books. Presuming that we do not have a Government of a particular colour who wish to dash to the rescue, I propose a second option that is worth considering: a small charge for e-books. As somebody who inherently does not like paying for things, that does not come easy to me; however, because we are currently not prepared to pay the publishers, the books are simply not being released.
	I propose that the money generated from such a charge be ring-fenced and shared between the publishers and authors, and the physical community library, with the
	money generated for the latter being spent on enhancing provision and service, be that events, book stock—staggeringly, that accounts for only 7% of library expenditure—extending opening hours, outreach work and so on. The publishers, in return for getting financial compensation for their books being borrowed, would be encouraged to release some of their stock for free access. I have met a number of publishers, and they see that as an opportunity to promote upcoming authors and educational books.
	I also propose—again, this is controversial—that e-books be borrowed through a physical visit to the library, thus protecting footfall. That seems like madness in a digital world, but my fear is that if we make things too easy—I go back to the point about convenience—why would anybody buy an e-book or visit a library? Local authorities across the country would soon start cutting huge swathes of community libraries, which are very important, particularly for people getting their first opportunity to enjoy reading, such as younger people, and those who cannot afford e-readers.
	I also advise the Government to look to provide a uniform e-book service. Lots of local authorities have been signing up to the models currently available—at great expense—from the book stock fund. I fear that a number of authorities, through no fault of their own, will end up investing heavily in a “Betamax” option. Underlining all this, we should keep traditional books: paperbacks and hardbacks should always remain free, because they are the cornerstones of libraries.
	If we do nothing and do not convince the publishers to release their stock, library usage will continue to fall as people drift to e-readers and e-book provision in libraries remains insufficient. Local authorities will continue to invest in the wrong forms of technology, and we will miss out on the potential of e-books to attract new generations of readers.
	These are just ideas to start the debate, and I am delighted the Minister has agreed to carry out a review. I hope to secure a 30-minute debate in Westminster Hall, which will provide a great opportunity to discuss some of the points that have been made to me.

Helen Goodman: It is a pleasure to follow the hon. Member for North Swindon (Justin Tomlinson), who made a very interesting speech, to which I listened intently.
	I wish to speak about reform of the civil service. A well-functioning civil service is exceptionally important to the effectiveness of any Government, and we must get it right. I was therefore interested to see the Government’s White Paper on reform of the civil service. Ministers must be able to rely on civil servants and to be able to drive their work forward. I was a civil servant for 16 years, between 1980 and 1997, in the Treasury. Some 10 years later I returned as a Minister, serving briefly in the Cabinet Office and the Department for Work and Pensions. So I have experience of fighting on both sides of the barricades, as it were.
	I found that some aspects of the culture were unchanged in the 10 years that I was out of Whitehall, with some seemingly unchanged for 400 years. Coriolanus is told by Shakespeare to proceed by the procedure, and I
	think that the culture of process over delivery is a long-lasting one in Whitehall. For example, in 2006 an official who was working on the forecasting of the number of immigrants who would come from eastern Europe said, “We went through all the right processes. What more could we have done?” That forecast was out 30-fold.
	The good news is that we have a professional civil service that is largely free of corruption. I say “largely” because although we were all looking for more exchanges between the public and the private sector, those have sometimes engendered rather unfortunate behaviour. Our civil servants are also, by and large, intelligent and committed. The problems, however, are well rehearsed and some are mentioned in the Government’s White Paper. They include the fact that the civil service has a stronger capacity on policy than on delivery, which has been recognised as a problem in the British civil service since the Fulton report of 1968. In this White Paper, the Government say that only a third of projects are delivered on time and to budget. One point that they do not raise, but it is an issue, is the narrow social base and experience of civil servants, particularly senior officials. That leads to ignorance and naivety in areas of social policy. I noticed when I was a DWP Minister that I sometimes knew far more than my officials.
	Other problems include: the lack of specialist expertise in project management, in contracting and commercial work, and in finance and in human resources—those are all key management delivery skills—a culture of irresponsibility; weakness in long-term and strategic thinking; poor oral and communication skills; a focus on managing inwards and upwards, rather than downwards and outwards; and, I am sorry to say, a loss of administrative skills and honesty. For example, when I was a Minister I had my electronic signature put on documents that I had not seen.
	Does the Government’s White Paper address those issues? The answer is: up to a point. I notice that it is a document that calls for less bureaucracy, despite having three forewords. The proposal to have stronger management—the measure for pushing out the bottom 10% and boosting up the top 25%—is rather crude. I would have thought that a well-managed organisation would not need to use such crude management techniques. However, the Government note the importance of strengthening capabilities and of shared services, and they want to strengthen ministerial influence over senior appointments. I agree with what they are doing there, but I do not think that they are going far enough.
	The approach of “open” policy making is extremely complex. Obviously, Ministers want to be able to source ideas from people other than Whitehall officials, but the neutrality of officials is also very important and we need to hold on to it. The Government are going wrong in cutting too far, there are too many new-fangled financial mechanisms, such as payment by results, which will be more expensive than gilts, and they have not addressed the narrow social base and the experience situation.
	The crucial issue is accountability. Three basic types of accountability are possible in an organisation: hierarchical, market or democratic. In Whitehall, the most important of those is the democratic element. That means that Ministers can be responsible for policy and, if they are warned, for delivering failures, but that
	otherwise officials must be responsible for delivery. I totally support the work that the Public Accounts Committee has been doing in that regard.
	The negative needs a proactive solution. The Secretary of State should be able to appoint the permanent secretary from a shortlist that has been put together by the Appointments Commission. I had always thought that that was a good idea, but when I heard Lord O’Donnell, the previous Cabinet Secretary, say on Radio 4 that that was the one thing he did not want to happen, I knew that it was the lever that we must pull.

Peter Bottomley: I want to raise the question of leasehold valuation tribunals. I declare that my parents had to leave their home in the 1950s after leasehold reform. I also declare that I have an interest in a leasehold flat in Worthing, where the landlord is good, the managing agents are good and we are all happy. That is not true of all. There are about 1.8 million leaseholders in this country and the figure will grow. They pay about £3 billion a year in service changes, and that figure will grow, too. Not all landlords create problems, but some do; not all of those landlords are in the private sector. Some are in the public sector and I have come across a case in which a major London council was found to have been overcharging leaseholders enormously.
	I have taken up this issue because there was a long-running problem, which is now being resolved, in Oakland court in my constituency. I pay tribute to those on both sides who are helping to resolve it, but until it reached a resolution I described what was happening to people who, in the majority, are frail and elderly people in their 80s and 90s—those who are still alive since the case began—as, in effect, legal torture, to which they were subjected as they tried to get into the leasehold valuation tribunal proceedings. Appeals, delays and applications from the other side blocked them from being heard.
	Leasehold valuation tribunals are part of the residential property system that might properly be described as a non-departmental body. They replace the rent panels and I suspect that it falls between the Department for Communities and Local Government and the Ministry of Justice. They are probably more the responsibility of the former, but I stand to be corrected on that.
	I do not expect my hon. Friend the Deputy Leader of the House to respond to what I am saying today as I would much prefer to get a letter later. My request to him is that if in September it is possible to have a ministerial statement from the appropriate Minister or Ministers, saying that their officials have met together, taken advice from those who staff and sit on the leasehold valuation tribunals and listened to some of the organisations that have considered the issues, as well as stating how the Government assess the situation and intend to approach it in the future, I shall be grateful.
	Let me pay tribute to a liberal think-tank, CentreForum. I anticipate that it will bring out a guide to the issues in leasehold valuation tribunals and the reforms that are needed. Although it is not necessarily a true blue think tank, I welcome its proposals and look forward to reading its full report with great interest.
	When my constituents, ably led by John Fenwick, to whom I pay tribute, applied to the Bar Council pro bono unit to get representation, they made the point that when the leaseholders applied to challenge invoices for services that were not being provided, they were confronted by demands from solicitors and a barrister to the tribunal
	“to decline jurisdiction and…to dismiss the whole of the application as being frivolous, vexatious and an abuse of process, having no prospect of success.”
	If it takes two or three goes to get in front of a tribunal and the application costs, say, £350, there is a major problem that needs dealing with.
	The tribunals can be very useful for one group of leaseholders who are trying to get a recalcitrant fellow leaseholder to pay up when they are not paying their charges. A very good example appears in an article from 2007 by Liz Hodgkinson in The Daily Telegraph, talking about how they managed to get an order to make one leaseholder pay up thousands of pounds-worth of costs that they had not paid.
	My issue is about the inequality of arms that leads to oppressive behaviour by managing agents or freeholders. If leaseholders are faced with a freeholder or managing agent who has associated companies in which they do not declare their interest, we end up with the situations disclosed in leasehold valuation tribunal judgments, whereby each leaseholder may be asked to pay insurance costs of £6,000 or £7,000 when the appropriate cost is about £2,000. There are scandals that need exposing. We need publicity and better adoption of rules and guidance and, if necessary, the law—although I suspect that the registration of managing agents would do far more —so that many vulnerable and elderly people do not suffer.
	I am grateful to Martin Boyd of the Charter Quay residents association in Kingston. He points out that neither leasehold valuation tribunals nor the Department for Communities and Local Government
	“keep data on the effectiveness or otherwise of the legislation in terms of outcomes.”
	He notes that FOI disclosures show Ministers and their advisers what is going on.
	The DCLG and the Ministry of Justice probably have very few resources. There may be only one or two officials trying to look after those things, so the Minister has to accept the advice that not much is known and not much needs to be done. The Government’s policy, rightly, is for more leasehold flats, with greater enfranchisement for leaseholders to challenge oppressive costs. We need change, and I look to the Government to review whether staffing is appropriate and whether more people can be brought in to advise Ministers so that there is a better outcome.

Barry Sheerman: It is a great pleasure to follow the hon. Member for Worthing West (Sir Peter Bottomley), who is a personal friend. We have campaigned together on many things over the years.
	I am saddened by the issue I have to raise this afternoon. As a Member with reasonably long service, I have been very disturbed over recent months about the
	low morale among the people who make this place work. For the information of the House, over the past few days I have talked to chefs, kitchen staff, cleaning staff, visitor assistants, maintenance men and women, Library researchers, Doorkeepers, Committee staff, procedural Clerks, finance and legal workers, human resources staff, drivers, porters, attendants, curatorial staff, Hansard reporters, members of the media and events teams, accommodation staff and so on. I have done my homework, and I have never met a group of people so demoralised by what they have to put up with as employees of Parliament.
	We all rely on the staff in this place; we cannot provide a good service to our constituents without their support. This Parliament should be an exemplar of the best kind of employer, but I am afraid we are not the best employer. As I talked to members of staff, they constantly said, “It isn’t what is happening, it’s not knowing what’s happening.” There is poor communication.
	I am keen on management and I chair the all-party management group. I know a little about good management. If managers do not keep in touch with their stakeholders—all the people who make this place a success, and make it amenable to good working for Members of Parliament—and if they do not keep communication open and tell people what is happening, staff become disillusioned and unhappy in their role.
	Over recent months—perhaps longer—there is every sign that certain people who are influential in the management of this place believe that it is a business. It is a funny old business where people do not know quite when the House will be sitting. In 2007, we sat for 151 days, and in 2008 it was 150 days. In 2009, we sat for 134 days, in 2010—election year—128 days, and in 2011, 149 days. This is a hard-working House, but it works funny hours, because a lot of our job is done out in the constituency, where we look after our constituents and find out the information that we need to be effective parliamentarians. We cannot run this place as though it were a commercial undertaking; indeed, the House voted by a majority for changes in the sitting hours, which will make it even more difficult to run this place.
	We speak to members of staff who say, “All of us in this department, after 20 years of service, have been asked to reapply for our jobs”, and to people in catering who say, “We all hear that they will privatise this, and we will all be out of employment.” That is either true or false, but whatever is happening should be communicated to our members of staff, so that they have some assurance.

Helen Goodman: I am appalled and amazed by what my hon. Friend is saying. Does he have any sense of which departments are involved, and how many staff are being treated in this way?

Barry Sheerman: The research is quite difficult, but there are 78 senior managers involved in one way or another in the management of this place, and a range of interesting people are involved. We have in the House a business change manager, a director general of human resources and change, an assistant corporate risk management facilitator, and an implementation manager. We have an awful lot of managers—and I am sure that, according to their lights, they are doing a good job.
	What I am saying to the House is that we should take the welfare of the people who make this place work very seriously indeed.
	There is another really worrying thing, apart from the welfare of the people who work here and have, over the years, put so much into their work. I am not talking about well-paid people, or people who have the most comfortable life in this country, in terms of their pay and conditions. I am also talking about the people in the Palace involved in security, who believe that security is threatened by the lack of morale here. They are trying to do the job with staff cuts, and with a declining number of people involved. I had a hand in improving the education offering in this place. It is so nice to see many more people visiting, and lots of children on educational visits. Interestingly enough, as was pointed out to me when I tried to do my research, the downside—if there is a downside—is that this becomes a busier place to manage, in terms of numbers and security. It cannot be all one way.
	The reason why I asked to speak in this debate is that there are very grave concerns about security, if some of the voices that I have listened to are right. Is it not about time that the management of this place got better, so that we can communicate with people in all the jobs that I enumerated? We serve our constituents best if we are served well by those people. We now have time to reflect on what we are doing to the people in all these departments, and to communicate and manage better. We Members of Parliament are the ones who will benefit from that change.

John Hemming: Civil liberties are defined as
	“the rights guaranteed to citizens or residents of a country or territory as a matter of fundamental law”,
	and are often human rights. One of my concerns on the subject is how workable the UK’s system is for many people in this country, or for those who leave this country to get away from things here. Mental capacity is one of the areas of concern; often, if a person wishes to challenge a judgment that says that they are too stupid to instruct a solicitor, they will not find a solicitor who is willing to take an instruction. Also, they will not be able to get papers accepted by the law. I have cited a number of cases, and I am very concerned about the continuing lack of scrutiny of mental capacity law.
	My early-day motion 334, which I will not read out, as everyone knows it so well, looks at the issue of court judgments. Obviously, a legal system needs court judgments, but we have a serious problem with delays in getting court judgments. If one cannot get the court judgment, one cannot explain to the appellate court what is wrong with the process.
	The Republic of Ireland’s Refugee Act 1996—this is relevant—defines a refugee as
	“a person who, owing to a well founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his or her nationality”.
	If people have a well-founded fear of persecution as a result of their political views, they are refugees. There are five or six people in the Republic of Ireland and one person in Namur in Belgium who have left the UK
	because of the way in which they were going to be treated by the judicial system and what was proposed by the family division. I have cited the case of Toni McLeod. I reported on her child protection conference papers and the fact that there were concerns that she had been involved with the English Defence League. The judgment stated:
	“The first concern…related to the mother’s association with the English Defence League.”
	The second concern was that
	“the mother is someone who reacts adversely to criticism and advice from professionals.”
	The third concern was that
	“the mother demonstrated a lack of insight into her children’s emotional and social needs”,
	partly because she had drawn her child’s attention
	“to her campaign against the family justice system and her belief that social workers tell lies.”
	We have a serious problem if the system proposes to take a new-born baby from someone because of that person’s political views. That is clearly a form of persecution: it has been done in the past and it is still going on today. There is a second case in Ireland—not in Cavan; oddly enough, four of these cases are in Cavan, which surprised me—in which someone was deemed a threat to his children because he expressed concern about the integrity of the system. Professor Jane Ireland, who undertook research on psychologists’ reports, showed that in the family courts—not the court of protection—of 124 reports, two thirds were either poor or very poor.
	That raises concern in relation to the issue of mental capacity. People’s legal existence is removed because a psychologist says that they are too stupid to instruct a solicitor, or do not have the mental capacity to do so. There are many other things that need to be said about that.
	I am lucky to have the opportunity to introduce a private Member’s Bill. Second Reading will take place on 26 October, and I shall explain why it is such a good Bill and can fix some of the problems in the system. Everyone knows about the process for such Bills: I need to consult the Government and see to what extent they respond to my concerns. Having discussed the matter quite widely, I hope to publish a draft of the Bill this week. The measure may be significantly different on Second Reading, because the Government may say that under no circumstances will they allow the measure through. There are difficulties, even though the legislature has secured greater independence from the Executive, in getting things through against strong Government opposition. I intend to send the measure to the Opposition, too, as well as other political parties to seek their views on these issues.
	It may surprise Members that some parts of the measure are necessary, but it deals, first, with the right to report wrongdoing. The Health Professions Council still refuses to investigate allegations against psychologists —and we must remember that those psychologists can paint people as non-persons and make them into secret prisoners—so we must do something about that. Secondly, we should have academic scrutiny of the proceedings, so that we can check that they have intellectual integrity. At the moment, things operate in a vacuum without being peer reviewed and so on. There is not even a Daubert process.
	Thirdly, and importantly, children in care do not have a voice. They are not listened to, and there is no proper remedy for them. When they leave care, they are often subject to discrimination, so I hope to propose in the Bill to improve the situation for children in care and after they have left care. I have only a few more seconds, so I shall not go into much more detail about the Bill, but I hope to publish it later this week. There are serious problems that need to be dealt with, and I hope to have hon. Members’ support in doing something about that on 26 October.

Caroline Lucas: I am grateful to have this opportunity to call on the Government urgently to investigate how a land value tax might be introduced to replace, first, business rates, and then council tax. I call for this because it would be more progressive and fair, it would help to prevent property speculation and it is a potential means of redistributing wealth. I am also encouraged by the fact that land value taxation has long been a key policy of one of the coalition Government partners. I hope that the robust reports on LVT from the likes of the Institute for Fiscal Studies, as well as debates such as this, might help to persuade the other partner.
	As hon. Members know, LVT is a tax or levy on the value of land that takes account of any planning permission associated with it but not of any improvements made to the site such as buildings. For domestic property, for example, the house price includes both land and building values, but LVT would apply only to the land that the house stands on. LVT encourages efficient and sustainable use of land, as owners of derelict land or properties that they have deliberately allowed to become run down pay the same as those who take care of their properties. It therefore has the potential to bring more brownfield sites into use and to ease pressure on green belt. Building in towns and cities would become more efficient, urban sprawl could be reduced, and speculative land banking—for example, by big supermarkets—could be discouraged.

Jonathan Lord: The hon. Lady cites all sorts of terrible, egregious cases, but what about the widow who wants to carry on living in the family home but does not have much income or spare capital? Would she force her to move home because of these taxes?

Caroline Lucas: I thank the hon. Gentleman for his intervention, not least because it gives me the opportunity to reassure him that I certainly would not be asking that widow to leave her home. What I am asking the Government to do—I have drafted a private Member’s Bill to this effect—is to research how we would implement a land value tax. Among the provisions that we would need to consider is how to protect the widow in the case to which he alludes. For example, one could give her the option of continuing to pay council tax until she dies or moves house, and if she moved house one could think about how to introduce the land value taxation at that point. I assure him that I certainly do not envisage a scenario where this measure would force people to leave their homes. It would have to be brought in gradually.
	I stress that my private Member’s Bill asks the Government to research this and look into the modalities of introducing it, transition periods, and so on.
	One of the great advantages of a land value tax is that it would be very hard to dodge, avoid or evade. It would encourage more efficient and sustainable use of land and avoid distorting business behaviour, as our current business rates do. Business rates are levied as a percentage of the estimated rental value of the property, and the effect of that is to skew economic activity away from property-intensive production and to create a perverse incentive not to use or properly develop brownfield land first. Crucially, an LVT could discourage boom and bust in property, giving incentives against disproportionate amounts of capital being tied up in property and unsustainable accumulation of debt.
	Support for this idea comes from interesting quarters both historically and today. For example, in February this year, Samuel Brittan said in the Financial Times that
	“the case for a land tax is one of the oldest and least disputed propositions in economic thought.”
	He went on to explain:
	“Many chancellors have said that they would jump at a tax that had no disincentive effects on work or enterprise but had a strong redistributive element.”
	Samuel Brittan is in very good company. Winston Churchill, speaking in 1909, put the argument in favour of LVT rather eloquently:
	“Roads are made, streets are made, services are improved, electric light turns night into day, water is brought from reservoirs a hundred miles off in the mountains—all the while the landlord sits still. Every one of those improvements is effected by the labour and cost of other people and the taxpayers. To not one of those improvements does the land monopolist, as a land monopolist, contribute, and yet by every one of them the value of his land is enhanced.”
	In addition to that, last year we had the heavyweight report from the IFS that was commissioned from the Nobel prize winner, Sir James Mirlees; it is known as the Mirlees review. It clearly recommends that the Treasury take LVT seriously. It says:
	“This is such a powerful idea, and one that has been so comprehensively ignored by governments, that the case for a thorough official effort to design a workable system seems to us to be overwhelming.”
	In responding to the questions that I have put to the Government so far on LVT, they have always fallen back on the work done by Sir Michael Lyons in his 2007 inquiry into the role, function and funding of local government. There are many criticisms of the Lyons report and there have been dramatic economic changes since it was released, the most obvious of which is the 2008 crash, which make Lyons’ analysis of land value taxation out of date.
	We need a study into the practicalities that looks at how we would bring in an LVT, who would be the winners and losers, and what transitional measures would be needed. The evidence suggests that such a measure would be broadly progressive. In other words, those who can afford it would pay the most and those who can least afford it would pay the least. I hope that the Government will use the response to this debate to reply positively to the broad cross section of people who are saying that this idea has potential. We now need research into how it would be implemented.
	The practicalities of land valuation at the necessary level of disaggregation might seem daunting, but that does not mean that it is not possible. There is already a substantial apparatus designed specifically to record land and property values for business rates. Rating lists are compiled by the Valuation Office Agency, which in 2009-10 employed approximately 4,000 staff. New lists are compiled every five years. The infrastructure is therefore already there and could be used.
	As I said, I have introduced a private Member’s Bill which, if we are lucky, will be discussed in November. It calls on the Treasury to do a serious piece of work that looks into how land value taxation might replace business rates and, subsequently, council tax, and that takes account of transitional arrangements as necessary. I hope that the Government will take that proposal seriously. The economic case is strong. If we took the wider view to see how such a transition could be made, I think we would find that such a tax would be sensible, efficient, effective and progressive.

Several hon. Members: rose —

Lindsay Hoyle: I have to reduce the time limit to five minutes. I hope not to reduce it again, so short interventions are critical when people give way.

Robert Halfon: I want to make just one point about the transparency of petrol and diesel prices.
	The Government have stepped up to the plate in cutting fuel duty. Ministers have done more to cut fuel duty in two years than many Governments have managed. However, fuel duty is still a stealth tax. As the FairFuelUK campaign has pointed out, we are not straight with the public about how much tax they pay. I pay tribute to FairFuelUK, which is one of the most effective campaigning groups in our country.
	When I fill up my car, my receipt says, “Fuel: £50. VAT: £10.” That is wrong. If it was accurate, my receipt would say something like, “Fuel: £25. Duty: £25. VAT: £10.” There should be some mention of how much of that tax is spent on our roads. I want to make three brief points. First, I will explain that it was never meant to be like this. Secondly, I will say what I am proposing. Thirdly, I will say why transparency works.
	The history of car taxation is a textbook case of how a tax becomes entrenched. First, it is temporary and is hypothecated for a specific purpose. It is then expanded. Finally, it is folded out into general taxation. That is exactly what happened to fuel duty between 1909 and 1937. In the early 20th century, funding for roads was drawn mainly from local ratepayers. The so-called people’s Budget in 1909, which came from the Liberal party, put a new duty on motor spirit, or petrol, in the days before our European Economic Community membership forced us to introduce VAT. The duty was ring-fenced for a road improvement fund. The explicit promise of Lloyd George in his Budget speech on 29 April 1909 was
	“that the funds so raised will not merely be devoted exclusively to the improvement of the roads, but that they will be well and wisely spent for that end.”—[Official Report, 29 April 1909; Vol. 4, c. 497.]
	By the 1920s, the road fund was repeatedly raided to prop up the Treasury. At the same time, fuel duty was compounded by licence fees, vehicle taxes and so forth. Eventually, from 1937 motoring duty was treated as general taxation. By 1966, just 33% of the revenue was spent on roads, and by 2008, the proportion was just 20%. Over the years, a series of “temporary” increases have been brought in. The fuel duty escalator began, in a sense, with the Hydrocarbon Oil Duties (Temporary Increase) Act 1956, back when duty was fluctuating between 5p and 6p a litre, and VAT did not exist. The temporary increase was a mirage. Fuel duty is now 58p a litre, with 20% VAT on top—an increase of more than 1,000%.
	I argue that the tax burden should be clear and transparent on every receipt and every fuel bill. There should be also be some indication of how much is being spent on our roads. My receipt would therefore say, “Fuel: £25. Duty: £25. VAT: £10. Amount spent on roads: £7.” My hon. Friend the Member for Ipswich (Ben Gummer) made such a proposal for income tax, which the Chancellor welcomed. Let us do the same for petrol and diesel.
	Why is that necessary? First, because we should be honest with motorists. The average family in Harlow spend a tenth of their income on fuel, which is more than they spend on the weekly shop. In essence, they face fuel poverty and they have a moral right to know why their bills are so high. Tax transparency would also act as a deterrent to any Government hiking fuel duty without good reason, because people would see the increase on their receipts.

Martin Vickers: As always, my hon. Friend makes a compelling case on this issue. Does he agree that it is important not only that the ordinary motorist knows that information, but that the road haulage industry knows it? It has been crippled by heavy taxes.

Robert Halfon: My hon. Friend is exactly right, and I know that when he goes back to Cleethorpes, his constituents will thank him in the streets for the work that he has done with me to try to cut fuel duty.
	Tax transparency would also make it easier to hold the big oil companies to account. The Government say that their actions have a low impact compared with the huge swings in the oil price, and my proposal would give people hard evidence on a weekly basis of whether falls in the price of oil were being passed on to consumers. as recommended by the website with which I am involved, www.petrolpromise.com.
	My proposal does what it says on the tin. We need basic transparency about how much fuel duty people pay and where the money goes. That would be more honest, it would be a deterrent against tax rises and it would put pressure on the oil companies to be fair. I hope, if the House is willing, to introduce a private Member’s Bill on the subject later this year. In the meantime, I urge the Deputy Leader of the House to consider the proposal for the autumn statement.

Jim Shannon: I rise to bring to the House’s attention an issue of great importance to my constituency—fishing. We have debated that critical issue on many occasions in the House, and many Members have a particular interest in it. I wish to underline the
	need the EU Fisheries Ministers to give full consideration to how best to move forward in a positive fashion. We hear much negativity about fishing, but there are also a lot of positives.
	I represent the second-largest fishing village in Northern Ireland, Portavogie, a port that has borne the brunt of European legislation. There are days at sea restrictions, quotas on fishing catches and levels of bureaucracy that, to use a colloquialism, would choke a donkey. The number of fishing boats in Portavogie has reduced from a high of 110 to a low of approximately 60 today, and a high proportion of those are 10 metres or under. I can honestly recall being able to walk from one side of Portavogie harbour to the other without getting my feet wet, because there were so many boats in the harbour. It is very different today.
	Many people are annoyed by the situation, because there are enough fish to make the fishing industry sustainable. Scientific evidence shows that in the Irish sea, many fish stocks are regenerating. Cod, in particular, are starting to come back there.
	In June, EU Fisheries Ministers agreed to a phased discard ban, to be completed by 2018. The industry supports that ban on the wasteful practice of throwing dead fish back into the sea, but we need to know just when the Under-Secretary of State for Environment, Food and Rural Affairs, the hon. Member for Newbury (Richard Benyon), and his Department will have discussions with the fishing industry on how the rules and regulations will be implemented.
	There is a clamour for meaningful regionalisation and for power to be put back into the community. The EU has indicated that it intends to do that through the common fisheries policy, but there is growing concern about the approach agreed by EU Fisheries Ministers, which many feel will not deliver the regionalisation that we all want. Brussels will retain a veto over much of fisheries policy, so the fishing industry seeks reassurance that regionalisation will be meaningful and will help the lives of ordinary people. In particular, it should help the villagers of Portavogie to regenerate the industry and do better.
	There has been much talk about the maximum sustainable yield and the long-term management plans. In 2002, the world summit in Johannesburg stated, in loose terminology, that the maximum sustainable yield would be achieved “where possible”. How does the Department for Environment, Food and Rural Affairs see that fitting in with regard to the Irish sea? The Irish sea has mixed fisheries. As such, the impact on it will be different from that in other places.
	The long-term management plan has built up a backlog in the EU fisheries system. The next case to be reviewed is the cod industry, which is vital for the section of the fishing industry that has experienced most of the changes over the last period of time. There is scientific evidence that the cod are coming back to the Irish sea in numbers, but we need to know exactly what is happening.
	Finally, the ongoing dispute between the EU and Norway on the one hand, and Iceland and the Faroes on the other, has dragged on for three years. I understand that a meeting will be held on 3 September, when the EU, Norway and Iceland will discuss the disputes. What
	is the recent UK input to the EU on the issue? What is our position on the talks? We need reassurance that UK mackerel fishermen, including those from Northern Ireland, will be given an update on this matter.
	In conclusion, given the reduction of days at sea, often without due consideration of, or consultation with, the fishing sector, especially when current scientific information shows that the Irish sea is regenerating, and given that the fishing fleet is sustainable, that more jobs can be created, that more opportunity can be given, and that more economic advantage can be gained, I suggest, at this very late stage, that the fishing industry needs help, including from the Government.

Andrew Percy: The provision of rural broadband and the broadband delivery plan for the two counties I represent—the East Riding of Yorkshire and North Lincolnshire—are of great importance to my constituents. It is good that my hon. Friend the Member for Cleethorpes (Martin Vickers) is in the Chamber—he has been working in support of our plans in northern Lincolnshire.
	This is a massive issue in Brigg and Goole, where we enjoy particularly poor internet speeds. For example, Adlingfleet in my constituency has absolutely no broadband access. Large parts of the constituency suffer speeds to which urban areas had access a decade ago. There is clearly demand for improved broadband access in my constituency, as is evidenced by the demand surveys that my local team and I have delivered—the response rate is between 10% and 15% in a number of wards. That figure continues to grow.
	I am concerned about the growing digital divide in this country, with residents in rural areas missing out, which is why I welcome the Government’s broadband pledge and the broadband delivery roll-out. However, I shall talk about the specific plans for North Lincolnshire and the East Riding. My constituents are missing out on developments in health care, such as telehealth services, which will become increasingly important, and on educational opportunities, particularly continuing learning and adult education through distance learning.
	Around 25% of East Riding households are likely to be non-users of the internet. The problem is compounded by poor broadband speeds. In North Lincolnshire, 52% of children under the age of 15 are unable to use the same online tools at home as they use at school because of poor access, or because they have no access at home. I visited a school in Pollington, which is in the East Riding part of my constituency because pupils had written to me to ask me to see the poor broadband speeds for myself. The situation was fairly appalling—the children are unable to access basic education websites.
	We know the value of increased broadband speeds, so I will not go into them in too great a detail, but I want to speak briefly about the two delivery plans. I shall give an example of the cost savings that can be achieved with good broadband access. The average cost of residential care in North Lincolnshire is £18,000 a year. Telehealth care services can help an individual who wants to live at home retain their independence, and can produce savings of £11,000 a year, but poor access to broadband, which is necessary to support those services, obviously makes that much more difficult in our areas.
	In North Lincolnshire, the broadband bid is for £12 million, of which £2.62 million is being provided by Broadband Delivery UK. Both BT and Fujitsu have said that North Lincolnshire is one of their top six priorities out of 40 bids, but the Department for Culture, Media and Sport has ranked it only 23rd. I would like Ministers—I am happy for them to respond by letter—to look at the ranking that DCMS has given to the North Lincolnshire bid, particularly in the light of the priority that BT and Fujitsu have given to it, and to take into account the developments along the Humber to support the renewable energy and enterprise zones that we have and that will require much better broadband access. I also ask them to consider the funding from the European regional development fund. Our proposal involves using ERDF funding, but there is the concern that the Yorkshire and the Humber ERDF team might not have the capacity to deliver the project on time.
	I have two simple requests for the East Riding. We understand that a national contract has been let, but a lot of our broadband and internet access in the East Riding is provided by Kingston Communications. Will Ministers consider whether the unique situation, with KC as the dominant local supplier, will enable the council to go into a separate arrangement outside the national structures and procurement framework with BDUK? I would also appreciate it if Ministers could clarify the exact funding available to the East Riding, because there seems to be some concern about that. Broadly speaking, I welcome what the Government are doing, but I would appreciate it if Ministers could look at these requests.

Jeremy Corbyn: I wish to draw to the House’s attention the huge problems facing people living in the private rented sector in this country. This has to be seen in the context of the overall problems of housing supply and need in Britain. In 2010, 102,000 new properties were provided in this country, but every year approximately 230,000 new households are created. There are 2.8 million people on the waiting list for council housing in the whole country and 3 million people living in the private rented sector.
	I want to talk about the private rented sector because it has been the fastest-growing sector. Even if all the council housing I would like built was built quickly, an enormous number of people would still be living in the private rented sector. Private rents have risen at double the rate of wages over the past 10 years, while people living in the private rented sector are 10 times more likely to move than owner-occupiers. Furthermore, rents are rising fast despite the low level of wage rises at the moment and the relatively low levels of inflation. In other words, it costs more to live in private rented accommodation.
	Nationally, the number of people living in private rented accommodation has risen from 9% to 17% over the past 20 years and continues to rise fast. In my own borough, the number of people living in private rented accommodation is more than double the national average—about one third of my constituents live in private rented accommodation. Less than 30% are owner-occupiers, whereas the national figure is about 68%, although that figure is falling somewhat.
	The terms of tenancies and conditions for people living in private rented accommodation tell a very sorry story indeed. From the first world war to the 1950s, there was quite rigorous rent control in the private rented sector, and the sector was subsequently built out as slum clearance took place and council housing and owner-occupation developed. We have had a long period with very little council housing being built—although thankfully that is now beginning to change—but Britain also has the most lax system of rent control and tenancy control of any country in Europe. We have a system of assured shorthold tenancies—which give tenants a guaranteed tenancy of only six months and, after that, a two-month notice period—along with very high rents. In my constituency it is quite normal to find people living in private rented accommodation who are paying half their take-home pay—if they are in work—on their rent.
	We also have a housing benefit system that militates strongly against people in the private rented sector. The Government have introduced the rent cap, which has limited the levels of housing benefit being paid. I am now facing the trauma—and it is a trauma—of seeing large numbers of tenants in my constituency who were or are in receipt of housing benefit being forced to move out, because their housing benefit has been cut and their rents have gone up, and because they cannot afford to meet the difference from other benefits, if they are on them, or their wages. There is, in effect, a social cleansing of inner London going on because of the imposition of the housing benefit cap. I stress the point that a large number of people in receipt of housing benefit are working—albeit on low wages, but they are in work.
	The current situation is an utter disaster, but it does not have to be like this, and I hope that things can change. Germany, for example, has 60% of its housing provided by the private rented sector. Germany has permanent tenancies and rent controls provided, and a tax regime that encourages good rather than bad management. Germany has a much more stable community and society as a result.
	I hope that the House will be able to return to this issue. I hope to introduce a private Member’s Bill to bring about regulation, rent controls, decency and, above all, security in good quality homes for those living in private rented accommodation. This is a serious issue that must be faced for a large number of people in this country.

David Amess: There are a number of points I want to raise before the House adjourns for the summer recess.
	London’s air ambulance service—for which my hon. Friend the Member for Brentford and Isleworth (Mary Macleod) recently organised a reception—continues to do an amazing job. It helped a huge number of people in the London bombing, along with more than 2,000 patients last year, using a helicopter and rapid-response cars to deliver emergency medical care. However, the service is in need of a second helicopter, so I support its calls to raise £10 million over the next three years.
	Police and crime commissioner elections will be held in November. I would have thought that the last people we need standing are retired police officers, who will presumably have some sort of axe to grind. I would therefore like to know who exactly the PCCs will be
	accountable to, other than through the ballot box. What will their relationship with Members of Parliament be? These are important issues, particularly as police authorities have proved to be so ineffective.
	A constituent, Miss Tina Cannadine, suffers from a range of medical conditions, including myalgic encephalomyelitis, yet she has been refused disability living allowance after an appeal. I have concerns about the assessment system, which has denied Miss Cannadine her entitlements. It is clear that the required forms are too rigid, with no great leeway. They should be designed to help someone such as my constituent, not hinder them.
	BBC executives are still paid too much money. Despite a series of fiascos, culminating in the shoddy coverage of the diamond jubilee, the executive team and its stars earn hundreds of thousands of pounds each year. As licence tax payers, we pay their wages and we should be entitled to better services, and if they are not delivered, they should face a pay cut. However, I think that Lord Patten does a fantastic job, and I am still available as a TV presenter.
	The Government need to publish a robust liver strategy soon. Liver disease is a huge problem, but it is largely preventable. Urgent action is also needed on hepatitis C. Deaths from liver disease caused by hepatitis C are increasing rapidly, even though it is a preventable and usually curable virus. We can reduce deaths from liver disease by diagnosing and treating people living with this silent killer.
	Obstructive sleep apnoea is a little known but serious condition, where throat muscles relax and block the airways—sometimes one has only to look round the Chamber to see what a serious condition it is. I support the calls by the British Lung Foundation to have everyone with symptoms of OSA diagnosed quickly and accurately, and to ensure that they receive the highest standard of care for the treatment of their OSA. That would help to reduce NHS costs and improve patients’ quality of life.
	Maldivian students wanting to study in the UK face a challenge owing to the fiasco caused by having to get their visas via Sri Lanka. Their flights are also very expensive. As the Maldives were a British protectorate until 1965, I ask Her Majesty’s Government to do something to help those students.
	The lives of 3,400 members of the Iranian opposition are at stake in Iraq. The promises made to the residents of Camp Ashraf and Camp Liberty must be honoured, and we have to take a stand against the human rights violations occurring there.
	Unfortunately, I am concerned about a number of election practices in Southend. On polling day, people seem to be displaying their names and pictures right outside the polling stations. The policemen go round to the polling stations, but I wonder what they are looking for. The Electoral Commission needs to look into those issues.
	The highlight of the Olympic torch relay has already happened. It took place on 6 July when the torch came to Southend. It was greeted by a choir of 6,000 on the Esplanade singing the anthem “Let your light shine”, composed by Tolga Khashif. I congratulate Southend Metal and the council on doing a superb job of organising
	the event. An official who had been with the torch throughout its journey said that the Southend event was the best by a mile.
	Southend-on-Sea borough council was named local authority of the year 2012 at the Local Government Chronicle awards in March. I congratulate the mayor of Southend, Sally Carr, the chief executive, Rob Tinlin, and his hard-working officers, the leader of the council, Nigel Holdcroft and Councillor John Lamb, along with everyone at the civic centre on their fantastic achievements. I also hope to host a centenarians’ tea party this September, at which we hope to break the record in “Guinness World Records” again. My mother is now eligible to attend. It is for all those reasons that it is an absolute disgrace that Southend has not been designated a city.
	I wish everyone in the House a very happy summer recess.

Mary Macleod: It is a pleasure to follow my hon. Friend the Member for Southend West (Mr Amess) and to have listened to all his suggestions.
	On this, the House’s final sitting day before the biggest event that this country will probably ever host, it is only right and proper that we should mention the London 2012 Olympic and Paralympic games. It is now about 10 days until they start, and the M4 and A4, which go through my constituency, are starting to bustle as the athletes and officials arrive, along with the visitors who will be attending the games. The whole United Kingdom is looking forward to an excellent summer of sports and, of course, to lots of British medals.
	I would like to focus today on the legacy of the games and on what can be done to maximise it. In fact, I shall pick up on one of the points that my hon. Friend the Member for Southend West made. London’s bid for the games always included a comprehensive plan for a legacy, to make the most of the event for the whole UK. Among the priorities was the need to harness the UK’s passion for sport in order to increase grass-roots participation by young people and to encourage the whole population to become more physically active. These are the first Olympics to have a school games—that is likely to be copied by Rio in 2016, and further into the future—to which 14,000 schools across the country have signed up. The school games recently had their first finals at the Olympic park.
	An extra £500 million will go into sport in the next five years, and much has been done right across the country. Locally, 180 coaches have been trained, and today I have heard that St Mary’s tennis club in Isleworth has secured Olympic legacy funding of just under £50,000 to upgrade its clay court facilities. Many other programmes are being supported, including the Hitz rugby programme, the Dame Kelly Holmes Legacy Trust, and the Kickz football programme delivered by Brentford football club community sports trust and the Met police. There is lots going on.
	Another priority for the legacy plans is to exploit the economic growth opportunities offered by our hosting the games. The Prime Minister recently said that we expect the games to bring more than £13 billion of benefit to the UK. On the back of the games, VisitBritain
	has launched its biggest ever global tourism campaign, supported by the GREAT campaign, which is expected to result in 4.6 million extra visitors.
	A further aspect of the legacy will involve developing the Olympic park for regeneration, which is already happening, along with promoting community engagement and achieving participation among all groups in society through the games. I recently attended the Olympic torch relay in Osterley, which brought together primary schools from across the borough. I am now looking forward to my Olympic torch relay, which will take place on 24 July. It will come over Kew bridge before heading through Brentford and on to Hounslow.
	My key point today is how we build on that legacy. I would want to build on it by using part of that Olympic funding to support the London air ambulance. There is a great link, because the London air ambulance is supporting the Olympics, and sport is, in essence, about health. As my hon. Friend the Member for Southend West mentioned, we have one helicopter in London that covers the entire area within the M25. It supports over 10 million people over 600 square miles. Elsewhere in the country, there is one helicopter for 1.5 million people. If we make comparisons internationally, London looks way behind. We have one air ambulance and no back-up. Last week, maintenance was necessary, and no support was available.
	What the air ambulance does is give world-class trauma care, reducing death in cases involving such injuries by 30% to 40%. I am sure that if any Members or their families were involved in a serious accident and were in need of an air ambulance, we would want the London air ambulance to be available. On 7 July 2005, London’s air ambulance flew 26 missions to the various bomb sites and treated more than 700 people. Demand is increasing across London, and we have to remember that the London air ambulance is a charity—it is supported by the NHS, but it is a charity—and that it needs additional funding.
	I call on the Government and those responsible for legacy development to consider proposals to provide sponsorship support through the London Legacy Development Corporation, with agreement to use the Olympic logo and help fund another helicopter with the Olympic logo on it that would be part of the long-term legacy and would help to continue to save Londoners’ lives.
	I conclude by wishing every success to team GB and everyone involved in the games. I look forward to the London 2012 games and the opportunities they will provide to demonstrate to the world that London is truly the greatest city in the world.

Neil Parish: It is a great pleasure to speak in this pre-recess debate. I echo the words of my hon. Friend the Member for Brentford and Isleworth (Mary Macleod): we wish team GB the greatest success in the world. May I say to my hon. Friend the Member for Southend West (Mr Amess), who mentioned the Guinness Book of Records, that he should appear in it for the amount of stuff he can get into a five-minute speech about his constituency and events all across the world? He most certainly should be given such an award.
	To be serious, on 7 July, 4½ inches of rain fell in one day on part of my constituency—Axminster, Seaton and Uplyme. There was a great deal of flooding in Axminster, particularly in Willhayes park, where many bungalows were flooded. Several elderly residents were confined to their beds and literally had to be rescued while the water was rising in those bungalows. I have toured the area this last week with the mayor of Axminster, Councillor Andrew Moulding, who has set up a local fund to help residents. It is great to see how the local community has pulled together in Axminster; I was amazed at how stoic the residents whom I went to see were, considering that their houses had been flooded. Anyone who has been into houses that have been flooded will be aware of the smell and contamination that people have to go through.

Mel Stride: My hon. Friend is touching on an important point about the flooding that has affected many of us in the south-west. Will he join me in congratulating the Environment Agency on its sterling work, particularly in keeping residents fully informed of what was happening, including Members of Parliament?

Neil Parish: My hon. Friend must be a mind reader, because I was just about to mention the fact that the Environment Agency has been so good, especially in warning people and getting the warnings through early so that people could take action, where possible, to secure their properties with sandbags. A large flood happened in Axminster where there was a blockage across a railway under a large culvert. The water backed up and there was immediately a huge amount of flooding. In the long run, we need to not only get good flood warnings in place, but make sure that the culverts are clear and the rivers properly dredged so that we can get rid of the water when it comes.
	I accept that when 4½ inches of rainfall comes down in less than 24 hours, it is very difficult to handle, but we have to realise that the drainage channels and those rivers are all there for a purpose. That purpose is to drain. Yes, they are very pretty when the water level is kept high and they are allowed to silt up. Indeed, it all looks lovely until the rain starts to come down and we cannot drain the water away fast enough. I hope that Ministers and the Environment Agency will think seriously about that.
	We also experienced floods in Uplyme. Down by the village hall, culverts were blocked and, again, there was a great deal of flooding. Fewer properties were involved, but one was badly flooded when a stream came down from the hill. Again the rocks came out and blocked the pipe, and water cascaded through the building. As I have said, it is not possible to solve all the problems, but I think that we need proper drainage channels with proper grilles.
	Because I do not possess the ability of my hon. Friend the Member for Southend West to raise numerous matters during a short speech and am capable of raising only two or three, I shall now confine myself to raising the serious issue of the price of milk and the problems faced by dairy farmers in my constituency. The constituency contains a great deal of grassland, much of which is dairy farming land in the Blackdown hills and on the edge of Exmoor. The dairy farmers are not receiving
	the cost of production, and we need to do something about it, because they are experiencing a real problem. When 2,500 dairy farmers from all over the country come to a meeting in London—at Methodist Central Hall—the strength of feeling is clear. We cannot stand by while supermarkets drive the price of milk down by using it as a loss leader, as a result of which processors and farmers are squeezed.
	Members have asked what future young dairy farmers have. I think that they have a good future, but we must ensure that there are more co-operatives. Farmers must come together if they are to have more power in the marketplace. We must also think about future markets. The Minister of State, Department for Environment, Food and Rural Affairs, my right hon. Friend the Member for South East Cambridgeshire (Mr Paice), has told us that when he went to China he saw many milk products from France, Germany and the Netherlands, but none from Britain. I think that when we have an expanding market in China, it is essential for us to send our milk and milk products over there.
	If we do not export enough dairy products and create a demand throughout the country, and if too much liquid milk is flooding the market, it is very difficult to keep the price up for farmers. Farmers in my constituency need a future. They spend a great deal of money themselves throughout the community, and they need to be supported. I hope that the Minister will do something about that, and will establish contracts so that farmers can make a decent living.

Mr Speaker: I intend to call the Deputy Leader of the House at 6.40 pm. I now call Mr Martin Vickers.

Martin Vickers: Like my hon. Friend the Member for Brigg and Goole (Andrew Percy), I want to raise a matter that is particularly important to northern Lincolnshire. It involves a number of rail issues.
	Although yesterday’s announcement of investment in the east coast main line is valuable and welcome, towns such as Cleethorpes, which lie off the main line, also need serious consideration. It is essential for the increased capacity created by the forthcoming investment to allow either the main franchise holder or an open access operator to provide the much-needed direct passenger service from Cleethorpes to London.
	Twenty-five years ago, there were four direct trains from Cleethorpes to King’s Cross. They ran via Lincoln and Newark, although I think it more likely that the Scunthorpe-Doncaster route will be used in future. If the potential for economic growth is to gather pace—and the Government’s creation of enterprise zones constitutes recognition of that potential—we must improve connectivity with the capital. That will also boost the tourism economy. As Members will know, Cleethorpes is the jewel in the crown of the east coast resorts.
	I was encouraged by what the Secretary of State said yesterday about ensuring that UK-based producers benefit from the construction phase. I hope that everything possible will be done to ensure that, for instance, Tata Steel—which is based in Scunthorpe, where many of my constituents work, and whose most profitable line is the
	rail track that it produces—benefits from the contracts. We should think not just of those travelling on business, but of commuters and holiday travellers. Tourism is a vital source of revenue for struggling coastal communities. A seminar at the Department for Business, Innovation and Skills last week highlighted the need for connectivity to these resorts.
	In the Cleethorpes constituency, we have Immingham dock, which on Sunday will celebrate its centenary. About 23% of rail freight as measured by tonnes starts or finishes in Immingham. That highlights the importance of improved rail access. The local council estimates that by 2020 50% of containers arriving in the UK will be what the industry refers to as high-cube containers. We must therefore upgrade the gauge from the existing W8 to W10 and W12.
	Finally, may I mention the inquiry currently being conducted by the Office of Rail Regulation into higher access charges for freight? This could be detrimental not only to the port of Immingham, but environmentally. If we push more freight traffic on to the roads, that will increase CO2 emissions and be more damaging to our infrastructure, but, more importantly, it will reduce the quality of life of local residents.
	I shall conclude my remarks there, Mr Speaker.

Mr Speaker: We are extremely grateful to the hon. Gentleman. I call the Deputy Leader of the House.

David Heath: First, may I pay tribute to our former colleague, Marsha Singh, the former Member for Bradford West, who, sadly, passed away today in untimely fashion? He will be much missed, and I am sure the whole House will wish to send its condolences to his family and friends. May I also say that I, or the relevant Department, will write to any Member who has raised issues that I am unable to cover in the relatively short period of time now available to me?
	As always in such debates, we have had an excellent discussion. Some 19 Members contributed. The hon. Member for Worsley and Eccles South (Barbara Keeley) mentioned 2nd Battalion the Royal Regiment of Fusiliers, and I perfectly well understand why she might wish to represent her constituents in the Salford area who are rightly proud of the record of that battalion of the former Lancashire Fusiliers, with its proud record of service through the years, including in the Peninsula war and Gallipoli. We have debated these matters before in the House, however. Every Member will wish to place on record their appreciation of Army units in their own areas, but we must have a modern, efficient and effective armed forces and the Secretary of State for Defence has made clear his intentions. I shall pass on to him the hon. Lady’s reservations in respect of the future of 2nd Battalion the Royal Regiment of Fusiliers, however.
	The hon. Member for Isle of Wight (Mr Turner) mentioned matters to do with colleges in his constituency. He mentioned apprenticeships, and it is crucial that we build on our great success in increasing the number of apprenticeships. There were 457,200 apprenticeship starts in 2010-11. That is an increase of 63.5%, which is a terrific achievement, but I want to see it replicated in every constituency, including the hon. Gentleman’s.
	The hon. Gentleman also talked about the problems in respect of the Isle of Wight festival. I have some fellow feeling in that regard, as the Glastonbury festival site is on the border of my constituency, and we have on occasions had difficulties with rain and muddy conditions there as well. It is important that the promoters of festivals work very closely with local people. We have had a very good relationship over the years with the Glastonbury festival, and I am sure that he has good relations, too, with the Isle of Wight festival, but it is crucial that promoters and local people work together to the benefit of everybody.
	The hon. Member for City of Durham (Roberta Blackman-Woods) talked about further and higher education. I understand the points she made, of course, but I would just say to her that this year the proportion of school leavers in England applying to university is the second highest on record. That is extremely encouraging. The Government have also introduced the national scholarship programme, which will greatly help those who come from modest-income backgrounds. It is important that we maintain the principle that higher and further education is open to all and that we maintain social mobility. That is a thrust of the Government’s policy.
	The hon. Member for Harrow East (Bob Blackman) talked about the importance of bearing down on crime in the context of those who enter our country, and he is absolutely right: there is a need for a high level of co-operation between the UK Border Agency and the police, and I believe that is happening. In fact, there is evidence of that in his own constituency, with Operation Coffeeville. Encouragingly, not only were arrests made and successful prosecutions mounted; hopefully, the proceeds of the crime are being retrieved and at the end of the sentence served those people will be deported. That is the way the law should apply. The hon. Gentleman paid tribute to the police and he is absolutely right to do so. We sometimes forget how much we owe to our excellent police forces. He also discussed the closure of custody suites, and as he knows, I share his concern about that issue. It is a local, operational matter; nevertheless, he rightly mentioned it in this debate.
	The right hon. Member for Belfast North (Mr Dodds) talked about the huge changes in Northern Ireland over recent years, and the successes. I share in his celebration—so much is going on in the Province that, a few years ago, would have been unimaginable. If I were to feature one thing, it would be Her Majesty the Queen’s going to a Roman Catholic church in Enniskillen in County Fermanagh.

Nigel Dodds: indicated  assent .

David Heath: A few years ago, it would have been very hard for anyone to give credit to that idea. The right hon. Gentleman rightly pointed out that there are continuing concerns, but rather than looking always at the concerns, let us celebrate the success and the way the process has moved forward.
	The hon. Member for North Swindon (Justin Tomlinson) made some incredibly interesting points about e-books. He knows that the Government are trying to achieve fair remuneration for publishers and authors, and provide reassurance against the illegal use of copyrighted material. I think the Minister with responsibility for such matters
	intends to make a detailed announcement shortly, and what the hon. Gentleman had to say ought to feed into that process.
	The hon. Member for Bishop Auckland (Helen Goodman) made a very interesting speech, given that she has served as a civil servant, a Minister and a Member of this House. She talked about the culture of process over delivery within the civil service, and I agree with her that that is the risk. Not all civil servants take that view, but we need to focus on outcomes, and to be more innovative and less hierarchical. She criticised the White Paper for having three forewords; well, better forewords than backwards. Nevertheless, the Government are trying to achieve a better, more effective civil service, and she clearly shares that aspiration. She also mentioned the accountability of Ministers. Of course, that is precisely what we were getting at with the Public Bodies Act 2011. Too often, bodies were remote from Ministers and not accountable to this House. They have now been brought back in-house, where Ministers can account for their actions, and that is absolutely right.
	The hon. Member for Worthing West (Sir Peter Bottomley) kindly said that I did not need to respond to the detailed issues that he raised. He rightly divined that I was probably in a state of complete ignorance about leasehold valuation tribunals and their precise workings, but I will make sure that the Ministry of Justice writes to him on that subject.
	The hon. Member for Huddersfield (Mr Sheerman) talked about low morale among the staff of this House. I hope that that is not the case. Of course, I should stress that it is not a matter for Government but for you, Mr Speaker, and the House of Commons Commission. However, it would be a matter of great concern if the staff did not feel valued by Members of this House, because they do an admirable job that we consider to be of huge importance.
	My hon. Friend the Member for Birmingham, Yardley (John Hemming) continued his campaign on the family justice system. I draw his attention to the Crime and Courts Bill and, later, to the children and families Bill, which will give him opportunities to raise some of these issues. I think he wanted really to have a trailer for his private Member’s Bill, which he very successfully trailed in his speech. The same can be said of the hon. Member for Brighton, Pavilion (Caroline Lucas), who was trailing her private Member’s Bill on the subject of land value taxation. She correctly said that the Liberal Democrats, and previously the Liberal party, have a very long-standing attachment to this subject; in fact some of our members are hugely attached to it. What she described is not the policy of Her Majesty’s Government at the moment, and there are issues to address, one of which was raised in intervention on her, for those who are asset rich and cash poor. She recognised that, and we shall see what develops.
	The hon. Member for Harlow (Robert Halfon), again, was trailing a private Member’s Bill that he intends to introduce on petrol and diesel taxation. He spoke warmly of the 1909 people’s Budget, that great achievement of David Lloyd George—it has been downhill ever since then, until the past couple of years. The hon. Gentleman talked about tax transparency and the need for people to understand just how much goes in duty as part of their petrol bill.
	The hon. Member for Strangford (Jim Shannon) talked about fishing and represented very well the people of Portavogie in his constituency. He drew attention to the movement we have had in the right direction in recent weeks on the reform of fishing policies and the need, nevertheless, to be sensitive to the industry, and to the people in his constituency, in particular. I am grateful to him for raising that with us.
	The hon. Member for Brigg and Goole (Andrew Percy) talked about rural high-speed broadband, which is very dear to my heart. I could wax lyrical about the need for rural high-speed broadband in my constituency and even in my own village; I have often said that a man with a stick would be quicker than our so-called “high-speed broadband”. However, we are looking forward to the sort of change that is going to happen as a result of the Government’s programme on this matter. I do not know whether he was in the House for a previous debate of this kind when an Opposition Member gave his opinion that rural high-speed broadband was simply for “millionaires” to do their “internet shopping”. The hon. Member for Brigg and Goole and I recognise that that is not the case and that rural high-speed broadband is essential for communities up and down the country, be they in cities or rural areas, so that they can take a proper part in the modern world. I look forward to that happening. He raised a specific point, which I shall arrange for the Department to write to him about, on the position of Kingston Communications. I will pass that on to the relevant Minister.
	The hon. Member for Islington North (Jeremy Corbyn) talked about the private rented sector, which I know is a big feature in his constituency, although it is important right the way across the country. The most recent figures—this may not apply in Islington but it certainly applies across the country—show that the level of private rent is rising slightly less than general inflation at the moment, so private rental is becoming slightly cheaper. I appreciate that that has not been the case over an extended period. He will know about Sir Adrian Montague’s imminent report on institutional investment, and the key part of that is the overall strategy to increase the supply of new homes. I have to say that this is the key thing for housing policy: simply having more homes. If we have more homes, people will have opportunities to live in them and the price will be more achievable.
	The hon. Member for Southend West (Mr Amess) put in a bid to hired as a TV presenter on the BBC. I have to say that if he became one, the likelihood would be that an entire week’s productions would be concentrated within a half-hour TV slot—blink and you would miss it. People would miss something crucial because he covers so many areas. He covered the London air ambulance, which was a subject also raised by the hon. Member for Brentford and Isleworth (Mary Macleod). The air ambulance services across this country, both in London and outside it, provide an essential service. I applaud what they do, as I think it is terrific that they provide that level of service to people who otherwise would be in dire danger from the results of acute trauma. We need to find ways to ensure that it is funded. There has been a debate on this subject recently
	and I will not reiterate the points raised by the Minister then, but its importance is clear.
	The hon. Gentleman raised police and crime commissioners, his constituent Tina Cannadine and her difficulties with DLA, BBC executives, hepatology, sleep apnoea, the problems of students from the Maldives in getting their visas, Camp Ashraf and Camp Liberty, election fraud and the Olympic torch. I am sure that Southend did a very good job with the torch, but I was told by officials that the performance in Somerton was the best that they had seen in the country. Surely they are not saying to us all that we are providing the best coverage of the Olympic torch.
	I congratulate Southend borough council on being council of the year. The hon. Gentleman has every reason to look forward to his centenarian’s tea party with his mother, Maud. I feel like I know his family as well as I know that of the hon. Member for Wellingborough (Mr Bone), they are mentioned in debates so often. We congratulate her and look forward to that happy occasion.
	The hon. Member for Brentford and Isleworth talked about the Olympic legacy, which is so important. We are looking forward to that great event, which will be good for sport, for business and for regeneration in this country, but we must ensure that every bit of it leaves a lasting legacy. It should not be something that simply passes, goes and is seen no more. We should benefit from it in the long term and the hon. Lady is absolutely right that we need to maximise that benefit, not just in the east end of London, which will clearly benefit, but across London and across the wider country.
	The hon. Member for Tiverton and Honiton (Neil Parish) talked about the flooding in his area, particularly in the Axminster area. I do not think that there is anything more distressing than flooding. We have experienced it—I found myself in a car that I had to abandon through the windows a few years ago, because it was caught in flood water—and it is frightening, distressing and, for those whose homes are wrecked, it can be a long time before things are back in order. I am grateful to him for raising the issue today, as well as the work that is done by so many of the agencies involved, including the Environment Agency, which takes a lot of trouble to give proper warning. I am also grateful to him for stressing the need for drain and culvert clearance, which are a contributing factor. Nothing will stop flooding when we have torrential rainfall, but if we ensure that drains and culverts are properly cleared we can at least contribute towards mitigating the consequences.
	Last but not least, the hon. Member for Cleethorpes (Martin Vickers), who is another Member whose constituency I feel I have got to know better over the past couple of years, talked about rail improvements. I think he was probably in his place yesterday when we heard the announcement from the Secretary of State of the £9.4 billion package, which is excellent news.
	I wish all staff of the House well over the recess, as well as all Members of the House and you, Mr Speaker. Let us look forward to a very enjoyable recess and a wonderfully successful Olympics.
	Question put and agreed to.
	Resolved,
	That this House has considered matters to be raised before the forthcoming adjournment.

Sittings in Westminster Hall (E-Petitions)

Mr Speaker: I inform the House that I have selected amendment (a).

Greg Knight: I beg to move,
	That the following changes be made to Standing Order No.10 (Sittings in Westminster Hall) until the end of the next session of Parliament:
	(1) In Standing Order No. 10 (Sittings in Westminster Hall):
	(a) in line 3, at the end, add the following new sub-paragraph—
	‘(za) on Mondays beginning at half-past four o’clock and continuing for up to three hours, if the Backbench Business Committee has reported its determination that a sitting in Westminster Hall to consider an e-petition or e-petitions should take place on that day;’.
	(b) in line 28, at the end, add the following new paragraph—
	‘(3B) (a) The business taken at a Monday sitting in Westminster Hall shall be the e-petition or e-petitions which the Backbench Business Committee has determined should be debated, and each such e-petition shall be debated on the motion, That this House has considered the e-petition from [petitioners] relating to [subject of petition].
	(b) Paragraph (10) of this Order shall not apply to proceedings under sub-paragraph (a) of this paragraph; no dilatory motion may be made in relation to proceedings under that sub-paragraph except by a Minister of the Crown; and the question on any such dilatory motion shall be put forthwith.’
	(2) In Standing Order No. 14 (Arrangement of public business), line 50, at the end, add:
	‘(3AA) In addition to those days allotted under paragraph (3A) of this order, the Backbench Business Committee may determine that a sitting in Westminster Hall may be held on a Monday in accordance with paragraph (3) (za) of Standing Order No. 10 to consider e-petitions.’
	(3) In Standing Order No. 152J (Backbench Business Committee), leave out from ‘with’ in line 39 to ‘of’ in line 40 and insert ‘paragraphs (3A) and (3B)’.—(Mr Knight.)
	If the signatories to the amendment do not delay matters further, I am happy to accept it.
	Amendment made, in line 2, to leave out ‘the next’ and insert ‘this’.—(Mr Bone.)
	Main Question, as amended, put and agreed to.
	Ordered, That the following changes be made to standing orders, until the end of this session of Parliament—
	(1) In Standing Order No. 10 (Sittings in Westminster Hall):
	(a) in line 3, at the end, add the following new sub-paragraph—
	‘(za) on Mondays beginning at half-past four o’clock and continuing for up to three hours, if the Backbench Business Committee has reported its determination that a sitting in Westminster Hall to consider an e-petition or e-petitions should take place on that day;’.
	(b) in line 28, at the end, add the following new paragraph—
	‘(3B) (a) The business taken at a Monday sitting in Westminster Hall shall be the e-petition or e-petitions which the
	Backbench Business Committee has determined should be debated, and each such e-petition shall be debated on the motion, That this House has considered the e-petition from [petitioners] relating to [subject of petition].
	(b) Paragraph (10) of this Order shall not apply to proceedings under sub-paragraph (a) of this paragraph; no dilatory motion may be made in relation to proceedings under that sub-paragraph except by a Minister of the Crown; and the question on any such dilatory motion shall be put forthwith.’
	(2) In Standing Order No. 14 (Arrangement of public business), line 50, at the end, add:
	‘(3AA) In addition to those days allotted under paragraph (3A) of this order, the Backbench Business Committee may determine that a sitting in Westminster Hall may be held on a Monday in accordance with paragraph (3) (za) of Standing Order No. 10 to consider e-petitions.’
	(3) In Standing Order No. 152J (Backbench Business Committee), leave out from ‘with’ in line 39 to ‘of’ in line 40 and insert ‘paragraphs (3A) and (3B)’.

Mr Speaker: May I reciprocate the great courtesy shown by the Deputy Leader of the House? I wish him and all Members of the House an extremely relaxing and restorative summer recess.

PETITION
	 — 
	Access to Homeopathic Medicines

Jim Shannon: Homeopathic medicines deliver a health care option to many people, including in my constituency. For many of them, the issue relates to freedom and personal choice.
	The petition I present is from people in my constituency who are concerned that section 10 of the consolidated Human Medicines Regulations 2012 should remain unchanged. I believe the Government are not willing at this stage to agree a change, but a marker needs to be put down. A small but well co-ordinated group with an anti-homeopathy agenda must be resisted by MPs and by Government. Choice on access to homeopathic medicines is paramount, and it must be retained and enshrined by Government. The petition requests that the status quo continue.
	The petition states:
	The Humble Petition of the citizens of the UK.
	Declares that the Petitioners are concerned about proposed changes to the Medicines Act that may restrict access to homeopathic medicine.
	Wherefore your Petitioners request that the House of Commons urges the Government to ensure that any changes to the Medicine Act allow greater freedom to homeopathic practitioners to dispense remedies.
	And your Petitioners, as in duty bound, will ever pray, &c.
	[P001112]

BAIL (DANGEROUS DRIVERS)

Motion made, and Question proposed, That this House do now adjourn.—(Mr Vara.)
	Greg Mulholland (Leeds North West) (LD): On new year’s eve, 31 December 2010, as people in Otley and all over the country were celebrating, my constituent James Peter Still, known as Jamie to his family and friends, was doing what 16-year-olds were doing up and down the country. He was out enjoying the evening with friends. Tragically, at around 9 pm, Jamie was hit by a drunk and speeding motorist, who lost control of his vehicle and veered on to the pavement.
	Jamie was assisted by people at the scene, including regulars from the White Swan and Manor House pubs. He was rushed to hospital but died soon afterwards. His mother, who had rushed to the scene, was at his bedside. No other members of the family were able to get there in time to see him. His death left a family devastated and a community and town in shock.
	The driver had been out drinking. His blood-alcohol content was estimated at about twice the drink-drive limit. He had been travelling at speeds estimated at 50 mph in a 30 mph zone in the middle of the town. Shortly before the accident he was reportedly performing handbrake turns in the car park of a nearby garden centre. In addition, he had been using his mobile phone, and in the half hour before the crash had received no fewer than 12 calls from his girlfriend. She was pleading with him to stop driving. It was not until 24 May 2011 that the driver was charged with causing death by careless driving while under the influence of alcohol, and pleaded guilty to those charges. He was finally convicted at Leeds Crown court on 8 September 2011. He was sent to jail for four years and disqualified from driving for five years.
	The point of my debate and the campaign is that the driver who killed Jamie Still on new year’s eve was allowed to—and indeed did—carry on driving until his sentence, eight months later in September. The man who had killed someone by driving dangerously was allowed on the roads for a further eight months. Usually, an individual’s licence is suspended soon after a drink-driving offence, because prosecution is swift, but unfortunately, in this case, as the driver had actually killed someone, the prosecution took much longer, and the licence is not suspended until conviction. That is, in effect, a loophole that allows many people charged with death by dangerous or careless driving to continue to drive, long after they are arrested, and even charged, up until their conviction and sentencing; that can, as this case has shown, be many months later.
	I was pleased to meet the Minister, along with Jamie’s mother, Karen, his sister, Rebecca and his grandfather, Peter. I thank the Minister for meeting the family to hear their concerns, and I appreciate that he is looking into the matter. I was also very pleased to receive a response on the issue from the Prime Minister at Prime Minister’s questions. He said:
	“He raises a very important point about what happens in cases such as these and what one can and cannot do with bail conditions. I will certainly go away and look at that. It may well be that this is something that we can consider alongside the recommendations that we are considering about drug-related driving. There is more
	work for the Government to do in this area, and I will certainly listen to my hon. Friend’s and his constituents’ concerns.”—[ Official Report , 1 February 2012; Vol. 539, c. 822.]
	That was very welcome news.
	Let me make it clear that this is not an isolated case. The campaign group, RoadPeace, in its guide for bereaved families in precisely this situation, says:
	“Bail can be conditional or unconditional…Drivers charged with causing a death are not immediately banned from driving. Driving bans are imposed only if the defendant is believed to be at risk of reoffending, but this is rarely the case. If a driver has a driving ban as part of his bail condition and they are caught driving, they can be put in jail”,
	but
	“Insufficient priority is given to keeping dangerous drivers off the road. Driving bans are short and can overlap with custodial sentences. It is a sad indictment of our society that we will imprison drivers before we will confiscate their vehicles and that we will crush vehicles for being driven without insurance but not for being driven”
	in these cases.
	It is true that a driving ban can be handed out following a guilty plea, or prior to sentencing reports, but that is at the discretion of the trial judge, and is simply not being applied in many cases. If someone is accused of drink-driving but has caused no harm, they will lose their licence quickly, yet if a drink-driver has killed another human being, they can, and often do, hold on to their licence and continue to drive. We can only imagine the distress that Jamie’s mother, Karen, and his sister, Rebecca, had to face as a result of this man continuing to drive in the weapon with which he killed their loved one. Indeed, Karen says:
	“why does the law allow offenders such as McRae to continue performing the activities that led to someone’s death?”
	Recently, Humberside police banned two drivers who were caught being too drunk to drive following a night of watching Euro 2012. Those two men had their licences suspended immediately, yet in the case that I am raising, that is not happening, although there is a charge of death by careless or dangerous driving.
	The family and I are calling on the Government to look into making the suspension of driving licences in such fatal cases no longer discretionary, but mandatory. Currently, driving bans are imposed only if the defendant is believed to be at risk of reoffending, or a risk to the public, but that is rarely believed to be the case, and it misses the point about the distress that Jamie’s family had to endure as a result of the driver continuing to drive. It is surely possible to make a driving ban a condition of bail in all cases where an offender is charged with death by dangerous or careless driving.
	At the heart of the campaign is Jamie’s sister, Rebecca. Unbeknown even to her own mother, she decided, off her own bat, even though she was grieving, to start an e-petition calling for those who kill as a result of dangerous driving to have their licences suspended as a condition of bail. It has now received more than 12,000 signatures. We believe that that is possible, and I hope sincerely that the Minister will look into it.
	It is possible to apply the measure to people who have been drink-driving and have tested more than twice over the legal limit. The Institute of Alcohol Studies has suggested that
	“those at least twice over the limit or…have previous convictions should have their licence withdrawn as a condition of bail. The
	Government should be prepared to effect this by primary legislation and treat the bail condition as an interim disqualification.”
	To make the position clear, we are talking about suspension from the moment of charge until trial. If someone is found to be innocent, as applies to any bail condition, their driving licence would be reinstated immediately, so there would be no implication that this is in any way a suggestion of guilt.
	Jamie’s family believe that driving bans for such crimes are far too short and should not overlap custodial sentences. I urge the Minister to look at that because, as he knows, driving bans do overlap custodial sentences, which in many cases nullifies the driving ban. In this awful case, the driving ban was set at five years, but the custodial sentence was four years in jail, which means that if the driver served his full sentence—in reality he will not do so—his driving ban would last only a year after release. It is simply not acceptable that someone who has caused a death as a result of dangerous or careless driving and has behaved recklessly and criminally should be allowed back on the road after being out in society for just one year. The family feel aggrieved, as they have told the Minister, and believe that the five-year sentence handed down to the perpetrator is not enough, given that he knowingly took to the wheel of his car twice over the drink-drive limit.
	I am pleased that this is on the agenda. The family are grateful, and they feel that Ministers, including my hon. Friend the Under-Secretary, have listened to their campaign on what appears to be a loophole that could be closed fairly easily. I hope that my hon. Friend will take this forward, echoing the Prime Minister’s comment that he will look at that alongside tightening the drug-driving laws—something else that I support. I have pledged to the family that I will carry on campaigning alongside Rebecca, Karen and Peter, Jamie’s grandfather. It is astonishing that, despite their devastating loss, which can never be rectified—a hole that can never be filled—they still want to do something at least to prevent some of the pain and trauma from affecting other families. I will carry on campaigning with them until we have secured changes to achieve that. I thank the Minister for his interest, and I hope that he will work with me and the family to see what we can do to address some of these issues.

Crispin Blunt: I applaud my hon. Friend the Member for Leeds North West (Greg Mulholland) for his tenacity on behalf of his constituents and for securing this debate on an issue that he has already raised with the Prime Minister at Prime Minister’s questions. I would like to begin by expressing once again our sympathy to the family of Jamie Still, who was taken so early from them and in such tragic circumstances. As my hon. Friend reminded us, in April, he and I met Karen Strong, Jamie’s mother, as well as Jamie’s grandfather, Peter Strong, and his sister, Rebecca. We were able to discuss their concerns about the case in some detail. The Prime Minister has continued to take a personal interest in the case.
	Something that contributed in no small measure to the family’s distress in this case is the time that elapsed between the incident and the suspect being charged, which was no less than five months. Although it is
	essential in any case, let alone one with such tragic circumstances, that the right charge is brought against the suspect, it is right that we should seek to do better, and we are. We have just published our proposals to reform the criminal justice system to deliver swift and sure justice. A swifter outcome in this case would have been preferable for all parties.
	To explain the time taken in this case, I should point out that it is a fundamental tenet of the criminal justice system that due process is followed, so even when some evidence appears to be very strong, charging decisions cannot be made under the full code test in the code for Crown prosecutors until all the relevant circumstances have been investigated by the police and all relevant evidence has been reviewed by a prosecutor. The investigation and gathering of evidence can sometimes be a lengthy process, and it can take a considerable time from when an offence is committed to when a charging decision is made. The importance attached to such serious cases is reflected by the fact that the final decision on the most appropriate charge in this case was taken at one of the highest levels of the Crown Prosecution Service.
	However, after the decision to charge was made, it took another three months before the defendant was convicted and sentenced after he pleaded guilty to causing death by careless driving while under the influence of drink or drugs. This offence is an indictable-only one; in other words, it must be tried in the Crown court. In such cases, defendants cannot plead until they reach the Crown court. Until very recently, there was no formal opportunity for a defendant in such a case who wished to plead guilty to let the magistrates know. The criminal procedure rules have now been changed, with the result that an early appearance can be arranged in the Crown court when a defendant has signalled that he intends to plead guilty. Even when the defendant has not done so, it may be that the case could be identified by the CPS as one in which a guilty plea is likely and thus listed for an early Crown court hearing. Arrangements enabling this to happen—the so-called early guilty plea system—have been piloted in Liverpool, Bristol, Winchester and Reading, and are now being adopted in many more Crown court centres. Such initiatives complement the principles of swift and sure justice that underlie the recent White Paper on criminal justice system reform. However, my hon. Friend has made clear the pain of the eight months of seeing Max McRae, the guilty drunken driver, still driving, and I hope that the change that I have outlined might address that to some degree.
	The offender in this case pleaded guilty and expressed remorse to the court. A guilty plea is welcome, not only because it enables cases to be resolved more quickly but because it may indicate willingness on the part of offenders to face up to what they have done. Restorative justice can go further in helping offenders to confront the consequences of their actions and their impact on others. I am convinced that in the right circumstances a restorative process can be highly beneficial, but it can only meaningfully take place when offenders admit responsibility and they and the victims have been assessed as fully able and willing to engage in it.
	The important thing about restorative justice is that it makes the victims central to the justice process. Jamie’s relatives expressed understandable upset to me that McRae offered remorse to the court but not to them.
	It is not clear what advice he received about whether such an expression would have been welcome or whether Jamie’s relatives had been counselled as to what they could expect in a proper restorative justice process. The only observation that I would make is that in over two years of meeting prisoners, this group of offenders tends to stand out as the most remorseful and the most conscious of the appalling and irreparable hurt they have caused. This case further convinces me of the need to improve our capacity for victims to have access to properly mediated restorative justice, and we are actively considering this in our policy development on victims and witnesses.
	The central issue for my hon. Friend is that the offender was permitted to continue driving while he was under investigation and awaiting trial. He will know that it is open to the police and the courts to require as a condition of bail, alongside any other conditions that are considered necessary, that a suspect or defendant must not drive while on bail. While a person is being investigated for an offence, the question of bail is an operational matter for the police. Once a suspect has been charged with an offence and appears in court, the question of bail becomes one for the court. If there are substantial grounds for believing that a suspect, if released on bail, will commit further offences, fail to surrender to bail, or interfere with witnesses, the police or the court may grant bail with one or more conditions attached. A condition that would prohibit a suspect from driving is an option if it is thought necessary and appropriate in all the circumstances of the case.
	The police and the courts have to make difficult decisions, balancing the need to protect the rights of individuals who are suspected of a crime against the need to protect victims of crime and all other members of the public. It cannot be the purpose of any bail condition to anticipate the punishment that a defendant might receive if he were convicted of the offence with which he has been charged, or that a suspect might receive if he were charged and convicted. The purpose of bail conditions is simply to protect the public from the consequences of further offending, or to secure the smooth running of justice by ensuring that the defendant turns up at a police station or in court.
	That is why, although it may be likely or even inevitable that a person who has been charged with certain motoring offences will be banned from driving if he or she is convicted, it does not follow that a driving ban should be imposed as a condition of bail. It is a question of risk. The difficult task facing the court, with the assistance of the Crown Prosecution Service, is to assess that risk.
	I recognise that there are cases where the nature of the offence suggests that a risk exists. It is arguable—and I have some sympathy with this view—that the incident in which Jamie Still was killed on that new year’s eve is
	such an example. An innocent young man died as a result of an incident that combined alleged careless driving and driving with significantly more than the permitted level of alcohol. It is arguable that a no-drive condition is, on the face of it, suitable in such circumstances. However, it is the duty of the court to carry out the risk assessment. The Crown Prosecution Service has a vital role to play in the process, because the prosecutor may make representations in relation to the grant of bail following Jamie’s case.
	Earlier this year, all prosecutors were reminded of the need for a careful approach on the question of whether to oppose bail in cases of bad driving that has resulted in death. The Director of Public Prosecutions is in the process of reviewing the Crown Prosecution Service’s policy on bad driving cases in general. That includes a review of the approach taken by prosecutors on the question of bail in such cases, especially where the incident results in the death of a victim. I anticipate that, with regard to fatal collisions, the guidance will emphasise the appropriateness of a no-drive bail condition when the facts and circumstances of the case suggest that if the defendant is released on bail, he will present a danger to other road users by committing further driving offences.
	There will be a public consultation on the review later in the year. That will be an opportunity for the public in general, Jamie Still’s family, my hon. Friend and any other family who have suffered a similar tragedy to make their views known. I will keep my hon. Friend informed about the progress on this matter.
	Essentially, it has to remain the position that every case will be treated on its merits. It is right that, where necessary, Parliament will provide statutory requirements for courts to follow and that organisations will provide guidelines on how to approach cases to make sure that there is consistency in standards. We ensure that legislation upholds the rights and needs of everyone who is affected by the criminal justice system in this country and we allow the professionals to apply the requirements correctly in each and every case.
	I congratulate my hon. Friend again on securing this debate and on raising this tragic case. I commend him for the tenacious way in which he campaigns on behalf of his constituents. I know that he will await the outcome of the review by the Director of Public Prosecutions, as we all will. Changes have already been made in the light of the tragedy that overtook Jamie Still and I anticipate that there will be further changes following the review.
	I wish you, Mr Speaker, and all the Officials of the House an enjoyable and agreeable recess as we enjoy the success of our Olympic athletes.
	Question put and agreed to.
	House adjourned.